Change Notification Form (PDF-124KB)
Use this form for change of address (home or worksite). For a name change, mail or fax a copy of the legal document authorizing the change to the board office. Your records will be changed in-house.
Wallet Cards - $10.00 - Send $10 payable to KY Board of Physical Therapy with your request to Board office.
Wall Certificates -$20.00 - Send $20 payable to KY Board of Physical Therapy with your request to Board office.
Licensure Lists and Labels
Verification Request (PDF-82KB) Do you need to verify your KY PT/PTA credential to another agency? Submit a signed request to the board office along with the fee of $15 for each verification.
Other State Boards Addresses and telephone numbers of other physical therapy licensing boards.