Department of Health
John J. Dreyzehner, MD, MPH, Commissioner
Board of Physical Therapy
Applications
Applications
- Physical Therapy & Physical Therapy Assistant Licensure Verification Form (PH-4126)
- Physical Therapy & Physical Therapy Assistant Duplicate License Form (PH-4128)
- Application and Instructions for Licensure as a Physical Therapist and Physical Therapist Assistant (PH-3124)
- Name and Address Change Request (PH-3619)
- Reinstatement Application (PH-2481)
- Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers (PH-3585)
- Affidavit of Retirement From Practice in Tennessee (PH-3460)
Governor Bill Haslam
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