Get Physical Therapy Form 1 - Application For Licensure - Op Nysed

Filling out the Physical Therapy Form 1 is an essential step in your journey to obtain licensure as a physical therapist in New York. This guide provides a comprehensive overview of the application process and detailed instructions for each section of the form to ensure a smooth submission experience.

Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the checkboxes at the beginning of the form to indicate whether you are applying for a physical therapist license, permit, or a physical therapist assistant license or permit. Ensure you select the correct option based on your qualifications.
3. Complete the personal information section. Provide your New York State DMV ID number (if applicable), Social Security Number, birth date, and contact details, making sure to indicate clearly whether your contact information is for home or business.
4. Fill in the educational history section. Include the name of every high school and college attended, dates of attendance, major concentrations, and the titles of the degrees or certifications obtained.
5. Answer the questions regarding previous licensure, any criminal history, or disciplinary actions. Provide complete and honest responses, and attach additional documentation if necessary.
6. Specify your disability status if applicable, and indicate if you require any special accommodations for testing.
7. Complete the child support obligation section. Indicate whether you are under an obligation to pay child support and choose one of the options available based on your situation.
8. Fill out your citizenship or immigration status. Select the appropriate option that reflects your current status.
9. Optionally, provide information regarding your gender and ethnicity for statistical purposes as requested in the form.
10. Grant permission for the New York State Education Department to share your examination results with your professional school for research and review purposes by indicating your consent.
11. Complete the affidavit section. Sign the document and ensure the notary section is also filled out by a licensed notary public.
12. Save your changes, download a copy of the completed form, and print it for submission.
13. Mail the completed form along with the appropriate fee to the New York State Education Department, ensuring not to send cash but rather a check or money order made payable to the department.

Begin your application process online today by filling out the Physical Therapy Form 1.