Oklahoma State Medical Board Physical Therapy Supervision Log - okmedicalboard 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of the licensee being supervised and their license number at the top of the form.
3. Indicate whether the license is temporary or regular by checking the appropriate box.
4. Fill in the names and license numbers of your supervisor(s) along with the employer or facility name.
5. For each quarter, record the year and document your direct observation times, ensuring your supervisor initials each entry for verification.
6. In subsequent columns, note down patient identifiers and facility locations where supervision occurred, along with any special notes in Column 7.

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