Forms

Continuing Education Course Application

• CE Application Form and Instructions for Course Approval (.pdf)

Each CE application submission is $100.00. Credit card payments cannot be accepted. Please make check or money order payable to the MN Board of PT.

Name Change Request & Duplicate License Request

• Name Change Request Form (.pdf)
• Instructions for notarizing a document or form (.pdf)

There is no fee for changing your name. The fee for a duplicate wall certificate is $20.00 and the fee for a duplicate license card is $20.00. Credit card payments cannot be accepted. Please make check or money order payable to the MN Board of PT.

Request for Verification of License

• Written Verification of License Form (.pdf):

Form to be mailed to Board Office with $25.00 fee in cash or via check or money order (made payable to the MN Board of PT).

To pay online using a credit card, log in to your online services account to request and pay for a verification of license.

Complaints Registration Forms

• Complaint Registration Form (.pdf)
• Report Registration Form (.pdf)

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