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  3. Arizona Statement Of Citizenship And Alien Status Form

Arizona Statement of Citizenship and Alien Status Form

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

Document Type
Applications
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Form
Licensing
Citizenship form revised 11202013.pdf
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Contact

Arizona State Board of Physical Therapy

1740 W. Adams, Ste. 2450

Phoenix, AZ 85007

Phone: (602) 274-0236

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