Reciprocity - PA gov - Commonwealth of Pennsylvania 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by completing pages 1 and 2 of the form. Ensure you provide an original signature, as faxed copies will not be accepted.
3. Attach a $20.00 application fee made payable to the Commonwealth of PA. This fee is non-refundable.
4. If you have a Pennsylvania employer, complete the top section of page 3 and provide this form to your employer for submission in a sealed envelope.
5. Request letters of good standing from any state where you have held a license, ensuring they are sent directly to the Board in sealed envelopes.
6. Provide a copy of the law and regulations from your original state at the time of licensure.
7. Request examination results from NTE to be sent directly to the State Board Office using code 8053 for Pennsylvania.
8. Attach a Curriculum Vitae detailing all employment periods and activities since graduation, formatted chronologically.
9. If applicable, include legal documentation for any name changes that differ from your submitted documents.

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