In order for the Board to change the name in which your PT or PTA license is issued, you are REQUIRED to submit one of the following via postal mail to the Board:
1) a certified marriage certificate specifying the name change following marriage;*
2) a certified divorce or dissolution of marriage decree specifying the name change, or;*
3) other certified court order specifying the name change.*
Please do not submit foreign marriage certificates that do not reflect your name
change following marriage, as the Board is unable to accept them for purposes of changing
your name on your license.
*You may submit a notarized copy. Please note that the notarization must be the original inked
notarization from the Notary and that the Board cannot accept copies of a previously notarized
document or faxed or emailed versions of the submitted documentation. If a Notary is unable or
unwilling to notarize your copy you will have to arrange to submit an original certified document.
How to obtain a notarized document:
1. Make a photocopy of the document (marriage certificate, divorce decree, etc).
2. Take the photocopy along with the original document to a Notary.
3. The Notary will look at the original document and the photocopy.
4. The Notary will sign/stamp/seal the photocopy and write a statement to the effect that they have viewed the original and this is an exact copy. Some Notaries will attach a paper (with a similar statement, signature/stamp/seal) to the copy.