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Licensees & Certificate Holders
Havasu Falls

Service Requests

A license verification is an official form verifying license/certificate details & discipline history. A license/certificate verification can be printed, free of charge, from the Board's Online Directory. If you require a verification sent directly from the AZ PT Board to another licensing or verifying entity, please review the steps

Fee: $15

To request a license/certificate verification:

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Document Request
  3. Follow the on-screen prompts to complete your request
  4. (You may upload additional forms for informational purposes but know that the AZ PT Board will send our own verification template)
  5. Click Submit and complete the payment screen(s)

When your service request is processed you'll be notified via email and provided a copy of your verification form.

To update Mailing/Residential Address and/or Employment Information. 

Fee: $0

To update your Mailing/Residential address or Employer Information, follow these instructions. 

  1. Log into your Licensee Portal
  2. To update your Mailing/Residential Address, use the left-hand menu and click Personal Information
  3. Update your Mailing/Residential Address as necessary
  4. Click Save
  5. To update your Employer address or information, use the left-hand menu and click Employment Information
  6. Follow the screen prompts to update an existing employer or add a new employer.
  7. NOTE: A blank employment end date denotes your current employer.

If the steps above are properly completed in their entirety, your change(s) will become immediately effective.

Email address updates can be completed through your Licensee Portal

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Personal Information
  3. Scroll to the email field and update
  4. Click Save, THEN
  5. Using the left-hand menu again, click Account Settings
  6. Select Change Email
  7. Follow screen prompts to complete your edits
  8. Click Save

The Board will use your email address for important communications. You are responsible for ensuring the Board has an accurate email address on file. Making changes as listed above will maintain consistency between your login email and account email to help ensure proper communication from the Board as well as prevent portal login issues.

A copy of your license/certificate suitable for framing and/or displaying on a wall. Does not indicate expiration date.

Fee: $10

To request a duplicate license/certificate:

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Document Request
  3. Follow the on-screen prompts to complete your request
  4. Select your payment method and click Process Payment to complete the payment screen(s)

When your service request is processed you'll be notified via email.

Your wallet card includes current expiration date.

Duplicate wallet cards are now self-service

Fee: $0

To obtain a duplicate wallet card:

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Wallet Card
  3. Click Download Wallet Card

Used to update a legally changed name. A name change request requires supplemental documentation as outlined in the instructions below. Requests lacking proper documentation will be rejected.

Fee: $0

To request a name change:

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Name Change Request as the Service Request Type
  3. Upload required legal documentation such as: Divorce decree (including seal and judicial signature); Marriage license / certificate; Court order (certified)
  4. Upload supporting documentation displaying your changed name: US Government Issued Identification
  5. Click Submit

When your request is processed you'll be notified via email. 

Used to change license/certificate status to Inactive - Not Practicing and requires uploaded forms. Indicates licensee/certificate holder is not currently working in AZ. Maintaining an Inactive - Not Practicing license/certificate requires renewal on same schedule as active licenses. Click here for more details. 

Fee: $0

To inactivate a license/certificate:

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Status Change Request
  3. Click Start
  4. Select Inactive - Not Practicing from the drop-down menu in the Requested Status field
  5. Enter a Reason for the requested change
  6. Complete the inactivation form in its entirety and upload it to your service request
  7. Click Submit 
  8. Await email confirmation that your service request has been processed and your license/certificate status has been updated to Inactive - Not Practicing
  9. CAVEAT: To maintain an Inactive - Not Practicing status, your license/certificate MUST be renewed on the same schedule as an active license/certificate. Failure to do so will result in a status update (post expiration) to Inactive - Administrative Suspension

When your service request is processed you'll be notified via email.

Used to change license/certificate status to Inactive - Retired and requires uploaded forms. Indicates licensee/certificate holder is no longer working as a PT/PTA in AZ or elsewhere. Maintaining an Inactive - Retired license/certificate requires renewal on same schedule as active licenses. Click here for more details. 

Fee: $0

To retire a license/certificate:

  1. Log into your Licensee Portal
  2. Use the left-hand menu and click Status Change Request
  3. Click Start
  4. Select Inactive - Retired from the drop-down menu in the Requested Status field
  5. Enter a Reason for the requested change
  6. Complete the retirement form in its entirety and upload to your service request
  7. Click Submit
  8. Await email confirmation that your service request has been processed and your license/certificate has been updated to Inactive - Retired
  9. CAVEAT: To maintain an Inactive - Retired status, your license/certificate MUST be renewed on the same schedule as an active license/certificate. Failure to do so will result in a status update (post expiration) to Inactive - Administrative Suspension

When your service request is processed you'll be notified via email.

For additional information and instructions regarding renewals, reinstatements, dry needling, PT Compact and other topics relevant to AZ licensed PTs and certified PTAs, visit the Other Applicants page.

(Laws) Arizona Revised Statutes; Title 32 Chapter 19

Applications
New Applicant
Other Applicant
Physical Therapist
Business Entity
Supervision
Physical Therapist Assistants
Foreign Educated
Continuing Competence
Licensing
Statutes and Rules

Arizona Revised Statutes Title 32 Chapter 19 is specific to the Board of Physical Therapy. This document serves as part of the AZLAW Jurisprudence Exam study materials; commonly referred to as AZLAW Statutes.

(Rules) Arizona Administrative Code TITLE 4 Chapter 24

Applications
New Applicant
Other Applicant
Physical Therapist
Business Entity
Supervision
Physical Therapist Assistants
Foreign Educated
Continuing Competence
Licensing
Statutes and Rules

Arizona Administrative Code Title 4 Chapter 24 is specific to the Board of Physical Therapy. This document serves as part of the AZLAW Jurisprudence Exam study materials; commonly referred to as AZLAW Rules.

ADA Accommodations For Testing

Applications
Form
Licensing

This form must be completed by those applicants seeking ADA Accommodations for the NPTE and/or AZLAW exams. Upload the completed form to your application and submit via the eLicensing system.

APTAAZ Practice Committee - Documentation Self Assessment Tool

Physical Therapist
Physical Therapist Assistants
Links

The Documentation Self Assessment Tool is a product of the APTAAZ Practice Committee. It is linked here as a professional courtesy. PTs and PTAs practicing in AZ bear the responsibility to ensure they are always practicing in accordance with the Board's statutes and rules.

APTAAZ Practice Committee Webpage

Physical Therapist
Physical Therapist Assistants
Links

The Practice Committee is a sub-committee of the AZ APTA. This webpage is linked here as a professional courtesy. PTs and PTAs practicing in AZ bear the responsibility to ensure they are always practicing in accordance with the Board's statutes and rules.

Arizona Statement of Citizenship and Alien Status Form

Applications
New Applicant
Other Applicant
Form
Licensing

This form must be completed in its entirety by every applicant for PT licensure or PTA certification. Upload the completed form to your application through the eLicensing system.

AZLAW Exam Handbook

Applications
New Applicant
Other Applicant
Physical Therapist
Physical Therapist Assistants
Foreign Educated

This handbook is the road map to the AZLAW Jurisprudence Exam. Use this handbook in conjunction with the Arizona Revised Statutes (Laws) and Arizona Administrative Code (Rules) as your study materials for the AZLAW exam.

Continuing Competence Audit Form

Continuing Competence
Form
Licensing

Licensees and certificate holders may use this form to independently track their own continuing competence activities. If audited, this form is to be downloaded and submitted electronically, with all associated continuing competence certificates of completion, to the Board office. Licensees and certificate holders selected for continuing competence audit will be noticed via certified mail.

Dry Needling - Frequently Asked Questions

Other Applicant
Physical Therapist
Physical Therapist Assistants
Licensing

Review these document to learn how to comply with the rules for training and education standards related to dry needling, which are effective July 1, 2015.

Dry Needling Training Submission Form

Other Applicant
Physical Therapist
Physical Therapist Assistants
Form
Licensing

Use this form to submit completion documents demonstrating compliance with the rules for Dry Needling training and education.

Inactivate a PT License or PTA Certificate

Other Applicant
Physical Therapist
Physical Therapist Assistants
Form
Licensing

If you wish to inactivate your AZ license or certificate, complete this form and upload to an inactivation service request through your eLicensing portal. 

PT Compact

Other Applicant
Public
Consumer
Licensing
Links

Public Records/Directory Request Form

Public
Consumer
Form
Licensing

Complete this form to request copies of records, including a Directory of Arizona PTs &/or PTAs. Fees are charged for copies of certain records. Mail completed form & payment to the Board's office as indicated on the form. Credit card payments are not accepted for Public Records requests.

A person may obtain additional public records related to any licensee or certificate holder, including dismissed complaints and non-disciplinary actions and orders, by contacting the board directly A.R.S. § 32-3214.

Contact Monica Crowley at [email protected] or 602-274-1072.

Required Reinstatement Documents

Other Applicant
Form
Licensing

Please complete the forms and upload the appropriate documents into the eLicensing System.

Retire a PT License or PTA Certificate

Other Applicant
Physical Therapist
Physical Therapist Assistants
Form
Licensing

If you wish to retire your AZ license or certificate, complete this form and upload to a "retire" service request through your eLicensing portal. NOTE, retiring a license/certificate indicates you are no longer working as a PT/PTA in AZ or elsewhere.

Third Party Verification

Public
Consumer
Form
Licensing

DO NOT USE this form if you have ever been a licensed PT or certified PTA in Arizona.  Previous or current AZ licensed PTs and certified PTAs must log into eLicensing to submit a Service Request for a license verification to be sent to another licensing board. If you have trouble logging into eLicensing contact staff. 

USE THIS FORM ONLY if you are a 3rd Party entity requesting verification of an Arizona licensed PT or certified PTA. Complete this form and submit with payment to request an official verification of licensure to be sent to another licensing board or college/university.