TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF PHYSICAL THERAPY
Forms
Title of Regulation: 18VAC112-20. Regulations Governing the Practice of Physical Therapy.
Agency Contact: Erin Barrett, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Henrico, VA 23238, telephone (804) 367-4688, or email erin.barrett@dhp.virginia.gov.
REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, General Assembly Building, 201 North Ninth Street, Fourth Floor, Richmond, Virginia 23219.
FORMS (18VAC112-20)
Application for Licensure by Examination to Practice Physical Therapy (rev. 8/2023)
Application for Licensure by Endorsement to Practice Physical Therapy (rev. 8/2023)
Application for Reinstatement to Practice Physical Therapy (rev. 8/2023)
Application for Reinstatement after Disciplinary Action to Practice Physical Therapy (rev. 8/2023)
Application for Reinstatement to Practice Physical Therapy (rev. 8/2024)
Application for Reinstatement after Disciplinary Action to Practice Physical Therapy (rev. 8/2024)
Application for Traineeship to Practice Physical Therapy Statement of Authorization (rev. 8/2023)
Application for Unlicensed Graduate Traineeship to Practice Physical Therapy Statement of Authorization (rev. 8/2023)
Completion Form for 320-hour Traineeship to Practice Physical Therapy (rev. 8/2023)
Verification of Physical Therapy Education for Graduates of Approved Programs Only (rev. 8/2023)
Continued Competency Activity and Assessment Form (rev. 8/2023)
Continuing Education (CE) Credit Form for Volunteer Practice (rev. 8/2023)
Application for Direct Access Certification (rev. 8/2023)
Direct Access Patient Attestation and Medical Release Form (rev. 7/2023)
Physical Therapy Name/Address Change Form (rev. 8/2023)
Request for Verification of a Virginia Physical Therapy License (rev. 8/2023)
Application for Reactivation (Inactive to Active) to Practice Physical Therapy (rev. 8/2023)
Out-of-State Practitioner Reporting Form (rev. 7/2023)
VA.R. Doc. No. R25-8053; Filed August 29, 2024