Section 16-110-40 - Requirements for temporary physical therapist license(a) An applicant for a temporary license who has applied for a permanent license, shall provide the board with: (1) The documents and evidence of qualifications as set forth in paragraph 16-110-20(b)(1) or (2); and(2) Evidence that the applicant has submitted to the board either an application to take the licensure examination within six months or evidence showing that the applicant has taken the licensure examination and is awaiting its results; or(3) For examination waiver, evidence that the applicant has fulfilled the requirements of section 16-110-20(h).(b) The applicant shall submit to the board a completed Statement of Supervising Licensed Physical Therapist, on a form prescribed by the board, from each proposed supervising physical therapist, to verify that each supervising physical therapist shall provide supervision to the applicant. The Statement of Supervising Licensed Physical Therapist shall indicate the name of the applicant, the name and license number of each supervising physical therapist, the date when the supervision shall commence, and shall be signed by each supervising physical therapist. The temporary licensee shall be supervised throughout the period of temporary licensure by a physical therapist holding a permanent active license.(c) An applicant may submit a written request to the board for a change in supervising physical therapist. The request shall include the reason for the change, the date of change, and a Statement of Supervising Physical Therapist from the new proposed supervising physical therapist. The request shall be signed by the applicant, new proposed supervising physical therapist, and the immediate prior supervising physical therapist, unless the applicant can provide adequate documentation to establish that the immediate prior supervising physical therapist cannot be contacted.(d) Except as provided herein, a temporary license shall expire within six months of its effective date or be terminated at an earlier date upon any of the following: (1) Termination of the supervisory relationship between the applicant and the supervising physical therapist verifying the supervision of the applicant;(2) The applicant's failure to pass the applicable physical therapy licensure examination identified in paragraph (a)(2);(3) Determination by the board that the applicant's qualifications for licensure are not as represented by the applicant at the time of application;(4) If the board determines that there is cause for termination due to the temporary licensee committing any act specified in HRS §§ 461J-12, 436B-19, or § 16-110-50; or(5) The person has received a permanent license.(e) The six month period for a temporary license may be extended to one year by the board for good cause. Only one temporary license will be issued per applicant.(f) A temporary license shall not be issued to a person who is not authorized to work in the United States.[Eff 6/5/87; am and comp 12/4/92; am and comp 10/13/94; am and comp 12/9/10] (Auth: HRS § 461J-5) (Imp: HRS §§ 461J-5, 461J-6, 461J-7, 461J-9)The amended version of this Section by Hawaii Administrative Rules Listing of Filings, 2015-01, February, eff.2/28/2015 is not yet available.