The New York State Education Department (“SED”) Office of the Professions (“OP”) is alerting everyone to a vishing scam that has been brought to our attention. Phishing—or “vishing”—scams impersonate SED employees or websites attempting to collect licensure and personal information from the licensee. If you receive an inquiry which you believe to be suspicious do not provide any information. To verify if the inquiry was from OP, contact OP directly using the following contact information. You may report suspicious calls or emails to the Federal Trade Commission.
  • NYSED Homepage
  • Disclaimer
  • Contact Us
  • NYSED Employment
  • Board Members Only

License Application Forms for Physical Therapist

Important Notice: DO NOT use Form 1 if you are already licensed in this profession in New York State. A New York State professional license is valid for life unless it is revoked, annulled, or suspended by the Board of Regents. To practice in New York State, your professional license must be registered. To renew your registration online, visit https://www.op.nysed.gov/registration-renewal/online-registration-renewal. If your registration has lapsed for longer than 4 months, submit a Delayed Registration Application.

All applicants for licensure must initially submit Form 1 along with the $294 (physical therapist) or $103 (physical therapy assistant) licensure and first registration fee. You must answer all questions and provide all information requested unless otherwise indicated. Failure to accurately complete all required parts of the application will delay its review. Additional forms below are required based on the licensure requirements of the profession. Do not use Form 1 to renew your existing license.

Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID, Social Security Number, and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.

Change Address or Name You are required to notify us within 30 days of any address or name changes. Please read the instructions to request this change.

Visit Form

This form must be submitted directly from the educational institution you attended.

  1. If you are a graduate of a program registered by the New York State Education Department as licensure qualifying or accredited by the American Physical Therapy Association (APTA), you must complete Form 2 as follows:
    1. Section l: Complete this section of the form before sending it to your educational institution, then forward this form to your academic institution for completion of Section ll, Part A and Part B. Be sure to sign and date item 8.
    2. Section ll: Have your school complete this section and forward it directly to the Office of the Professions. The Registrar or appropriate school official must return the completed form directly to the State Education Department, Office of the Professions, Division of Professional Licensing Services, Physical Therapy Unit, 89 Washington Avenue, Albany, NY 12234-1000.
  2. If you are applying for licensure based upon an education program that is outside the United States and NOT accredited by the American Physical Therapy Association (APTA), do not use Form 2. You must have your educational credentials verified by an independent credentials verification organization. Please refer to the "Education Requirements" section for the proper procedure.

Electronic Education Documentation

The Office of the Professions (OP) will accept official electronic transcripts and forms from educational institutions (i.e. colleges/universities) or designated third-party* transcript entities located in the United States, Canada, and the Philippines provided that:

  • The transcript is the certified true and official academic record and the document does NOT have an expiration date**.
  • OP can independently verify that the documentation is received directly from the educational institution’s registrar or officially designated third-party.
  • If a third-party transcript provider is involved, it is clear that the educational institution has designated the third party as the official sole provider of its transcripts.
  • The applicant had no opportunity to directly access or alter the transcript before it is sent or transmitted.
  • Any educational institution education documentation submissions should be made electronically to DPLSEduc@nysed.gov***.

*OP will only accept third-party submissions after we have determined that the arrangement between the educational institution and the third party is consistent with our security and verification standards.

**Transcript documents with expiration dates cannot be accepted. Expirations on links to the document are acceptable.

***Do NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.

Visit Form

If you are or have been licensed as a physical therapist or physical therapist assistant in another state or U.S. territory, you must also submit Form 3 to verify your license. A separate Form 3 must be sent directly from each jurisdiction in which you currently or previously held a license.

  • Section I: Complete this section of the form before sending it to the licensing authority. Make sure to include any fee required by that licensing authority for the certification or verification of a license. Be sure to sign and date item 7.
  • Section II: The state or U.S. territory in which you have previously applied for a license or been issued a license must complete this section and forward it directly to The Office of the Professions. The licensing authority must apply an original signature and stamp or seal and return the form directly to:

    The NYS Education Department
    Office of the Professions
    Division of Professional Licensing Services
    Physical Therapy Unit
    89 Washington Avenue
    Albany, NY 12234-1000.

Note: A Form 3 is not required for licenses/certificates issued by the New York State Education Department. Also, If the certification/verification documentation provided by a U.S. jurisdictions contains the same information requested in the Form 3, completion of a Form 3 for that jurisdiction is not necessary. For certification/verification documentation that does not contain the same information, a Form 3 will need to be completed for that jurisdiction.

Electronic Verification of Licensure, Certification and/or Examination

The Office of the Professions (OP) will accept electronic verifications of licensure, certification and examination completion from other licensing authorities located in the United States provided that:

  • OP can independently authenticate that the verification is received directly from the licensing authority.
  • The applicant had no opportunity to directly access or alter the verification before it is sent or transmitted.
  • Any licensing authority verification submissions should be made electronically to DPLSVerif@nysed.gov.*

*DO NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.

Visit Form

This form is for applicants seeking licensure in New York State by endorsement of a license to practice physical therapy issued in another jurisdiction.

Complete and send both pages of this form directly to the Office of the Professions at the address at the end of the form. Be sure to sign and date item 8.

You must also complete a separate Form 4A for each colleague you list on the Endorsement Applicant Professional Experience Record (Form 4).

Visit Form

This form must be submitted directly by a colleague. The Office of the Professions will not accept this form if submitted by the applicant.

  • Section I: Complete this section and send the entire form to your colleague to complete Section II. Be sure to sign and date item 7.
  • Section II: The colleague must complete this section, sign and date the form and return the entire form directly to the Office of the Professions at the mailing address at the end of the form.

Electronic Verification of Experience

The Office of the Professions (OP) will accept experience forms directly from supervisors provided that:

  • OP can independently verify that the documentation is received directly from the supervisor
  • The applicant had no opportunity to directly alter the experience form before it is sent or transmitted.
  • Any experience documentation submissions should be made electronically to DPLSExperience@nysed.gov*.

*Do NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.

Visit Form

Use this form ONLY if you are applying/have applied for a New York State Limited Permit as a Physical Therapist and Physical Therapy Assistant.

  • Section I: Complete this section.
  • Section II: Your supervisor must complete this section before you can submit it to the Office of the Professions at the appropriate address at the end of the form. It is your responsibility to ensure your supervisor fully completes Section II. Failure to complete this form will delay its review.
Visit Form

All applicants for a limited permit must initially submit Form 5 along with the permit fee ($70 for Physical Therapist and $50 for Physical Therapist Assistant). You must also submit a Form 5CS - Certification of Supervisor for Limited Permit along with your application.

Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.

Changes to Supervisors and/or Settings
If you change supervisors and/or settings, or you have to add or remove a supervisor or setting, after a permit is issued, you must obtain an amended permit using the Limited Permit Change Form. After changes are processed you will receive an amended permit. A fee is not required for an amended permit issued as a result of a change in supervisor or setting. You must also submit a Form 5CS - Certification of Supervisor for Limited Permit for each new supervisor you are adding (see Upload Additional Documentation above).

Visit Form

Last Updated: April 29, 2021