Va. Admin. Code tit. 18, agency 112, ch. 20, form FORMS (18VAC112-20)

Current through Register Vol. 41, No. 10, December 30, 2024
Form - 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 (rev. 9/2024)

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. Admin. Code tit. 18, agency 112, ch. 20, form FORMS (18VAC112-20)

Amended, Virginia Register Volume 40, Issue 3, eff. 10/25/2023; Amended, Virginia Register Volume 40, Issue 6, eff. 12/6/2023; Amended, Virginia Register Volume 41, Issue 03, eff. 10/23/2024; Amended, Virginia Register Volume 41, Issue 04, eff. 11/6/2024.