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Forms

ADA Accommodation Request

Address Change

Clinical Instructor CE Form

Application for Licensure -- PT or PTA

Attendee Course Prior Approval Application

Certificate of Dean/Register -- Physical Therapist

Certificate of Dean/Register -- Physical Therapist Assistant

Course Provider Approval Request

Duplicate License Request

Evaluation Skills Cheklist

Examination Information

Legal Name Change

Mailing List Request

PT Provisional Supervisory Request

PTA Provisional Supervisory Request

Statement of Complaint

Written Verification of License

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Lookup

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File

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LOUISIANA PHYSICAL THERAPY BOARD

2110 W Pinhook Rd. Suite 202, Lafayette, LA 70508

Phone: 337-262-1043

Fax: 337-262-1044

Intrastate Toll Free: 800-400-9110

Email: info@laptboard.org

The Louisiana Physical Therapy Board (LPTB) supports public access to information stored and maintained on this site. All the information provided is believed to be accurate and reliable; however, the Board shall not be held liable for improper or incorrect use of the data described and/or contained herein. REPORT FRAUD

In compliance with Act 655 of the 2018 Regular Legislative Session, the Board gives notice to its licensees and applicants of their opportunity to file a compliant about board actions or procedures. You may submit such complaints to one or more of the following organizations: