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Pa pta indirect supervision regulations

Initial bApplicationb - PT Assistant Indirect Supervision - PA gov 2026

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The document is an application form from the Pennsylvania State Board of Physical Therapy for individuals seeking to practice as Physical Therapist Assistants under indirect supervision. It outlines the responsibilities of applicants, including familiarity with relevant laws and regulations, application fee requirements, and necessary experience documentation. The form includes sections for personal information, verification of work experience, and supervisor certification. Additionally, it highlights a new requirement for training in child abuse recognition and reporting for initial licensure.

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Click ‘Get Form’ to open the Initial Application for Physical Therapist Assistant in the editor.
Begin with Part One, where you will enter your personal information including your name, contact details, and Social Security number. Ensure all fields are filled accurately.
Proceed to Part Two. If you have at least three years of full-time experience, complete section A. Otherwise, if you have 2,000 hours of supervised experience, fill out section B and attach your curriculum vitae detailing your work history.
In Part Three, if applicable, have your supervisor verify your experience by filling in their details and signing the form. Remember that all signatures must be original.
Finally, review the entire application for completeness and accuracy before submitting it along with the required fee.

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2015	4.9 Satisfied (59 Votes)

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