Title of Regulation: 18VAC112-20. Regulations Governing the Practice of Physical Therapy.

Agency Contact: Elaine J. Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, FAX (804) 524-4434, or email elaine.yeatts@dhp.virginia.gov.

FORMS (18VAC112-20)

Application for Licensure by Examination to Practice as a Physical Therapist/Physical Therapist Assistant (rev. 9/07).

Application for Licensure by Endorsement to Practice Physical Therapy as a Physical Therapist/Physical Therapist Assistant (rev. 12/07).

Application for Reinstatement of Licensure to Practice Physical Therapy as a Physical Therapist/Physical Therapist Assistant (rev. 8/07).

Instructions for Licensure by Endorsement to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of an American/Approved Program) (rev. 11/07).

Instructions for Licensure by Endorsement to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of a Non-American/Nonapproved Program) (rev. 11/07).

Instructions for Licensure by Examination to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of an American/Approved Program) (rev. 8/07).

Instructions for Licensure by Examination to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of a Non-American/Nonapproved Program) (rev. 8/07).

Instructions - Reinstatement of Licensure to Practice as a Physical Therapist/Physical Therapist Assistant (rev. 4/08).

Traineeship Application, Statement of Authorization (rev. 8/07).

Traineeship Application, Statement of Authorization (1,000-hour traineeship) (rev. 8/07).

Traineeship Application, Statement of Authorization, Relicensure (480-hour traineeship) (rev. 12/07).

Form #L, Certificate of Physical Therapy Education (rev. 7/08).

Continued Competency and Assessment Form (rev. 7/08).

480 Traineeship Completion Form (rev. 12/07).

Application for Direct Access Certification (rev. 4/09).

Instructions – Direct Access Certification (rev. 4/09).

Application for Licensure by Examination to Practice Physical Therapy as a Physical Therapist or Physical Therapist Assistant (rev. 1/11).

Application for Licensure by Endorsement to Practice Physical Therapy as a Physical Therapist or Physical Therapist Assistant (rev. 1/11).

Application for Reinstatement to Practice Physical Therapy as a Physical Therapist or Physical Therapist Assistant (rev. 1/11).

Instructions - Licensure by Endorsement to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of an American/Approved Program) (rev. 1/11).

Instructions - Licensure by Endorsement to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of a Non-American/Non-Approved Program) (rev. 1/11).

Instructions - Licensure by Examination to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of an American/Approved Program) (rev. 2/10).

Instructions - Licensure by Examination to Practice as a Physical Therapist or Physical Therapist Assistant (Graduate of an Non-American/Non-Approved Program) (rev. 2/10).

Instructions - Reinstatement of Licensure to Practice as a Physical Therapist or Physical Therapist Assistant (rev. 2/10).

Traineeship Application, Statement of Authorization (rev. 3/10).

Traineeship Application, Statement of Authorization (1,000-hour traineeship) (rev. 3/10).

Traineeship Application, Statement of Authorization, (480-hour traineeship) (rev. 3/10).

Form L, Certificate of Physical Therapy Education (rev. 3/10).

Continued Competency Activity and Assessment Form (rev. 3/11).

480 Traineeship Completion Form (rev. 3/10).

Application for Direct Access Certification (rev. 1/11).

Instructions – Direct Access Certification (rev. 2/10).

Patient Attestation Form (rev. 7/07).