P
HYSICAL THERAPIST NEW GRAD INSTRUCTIONS (TAKING THE
EXAM WITH MINNES
OTA)
Please thoroughly review these materials before submitting your online application. Any
processing fees incurred are your responsibility. The Board reserves the right to reject any
outdated applications submitted.
PLEASE NOTE: Before beginning the online application process, you will need to have
detailed information including:
Social Security number or Alien Card number or Tax ID number
If applicable other licenses or registration numbers, date issued & expiration dates
Record of Clinical affiliations
o INCLUDING: facility name, address, phone numbers from mm/yy to mm/yy and two
references (preferably 2 PTs) for each location with address and phone number
The following forms may be mailed to the Board office prior to submission of your licensure
application and fees. They will be placed in a pending file until your application file is
opened. After your file is opened – you will receive an email in regards to your online
application/account. You may view your application checklist online at any time during the
application process: https://phy.hlb.state.mn.us/#/login. If an item is marked “completed” no
further action is required.
A. FORMS TO PRINT OUT FROM THIS PDF AND HAVE MAILED SEPARATELY TO
BOARD OFFICE.
Notarized Affidavit with photograph (may be mailed by applicant)
Certification of Education (mailed by your school not more than 13 weeks prior to
graduation).
Recommendation Form (x2 mailed by the individual filling out the form).
B. DOCUMENTS TO BE MAILED DIRECTLY TO THE BOARD OFFICE
Official Transcript with a DEGREE GRANTED DATE posted (please have this sent
directly from your school to the Board office)
C. CRIMINAL BACKGROUND CHECK (CBC)
A fingerprint information packet will be emailed to you AFTER you submit a licensure
application and fees. A CBC is required for final licensure. CBC results can take 2-4
weeks.
D. MISCELLANEOUS INFORMATION
If you answer yes to any of the practice questions, please submit further legal/medical
documentation. For legal documents; have the county or jurisdiction provide the MN
Board with any legal documents (arrest records, court documents, dismissal of charges
etc.) related to the incident. They must be mailed to the Board office by the jurisdiction.
If the documentation cannot be mailed directly to us have the appropriate agency mail
them directly to you and do not open the envelope. Please put the sealed envelope in a
new envelope and mail to the Board office. If records are no longer available, have the
jurisdiction send a letter indicating this.
If you’ve had a name change, please submit a notarized copy of a legal document
supporting a legal name change.
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
How to obtain a notarized document:
Make a photocopy of the document (marriage certificate, etc).
Take the photocopy along with the original document to a Notary.
The Notary will look at the original document and the photocopy.
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.
Testing Accommodations (ADA) Please see the MN Board of PT’s website:
https://mn.gov/boards/physical-therapy/applicants/adatestaccomodations.jsp
MINNESOTA BOARD OF PHYSICAL THERAPY
University Park Plaza • 2829 University Avenue SE • Suite 420 • Minneapolis, MN 55414-3245
Telephone (612) 627-5406 • Fax (612) 627-5403 • http://mn.gov/boards/physical-therapy/
physical.therapy@state.mn.us • MN Relay Service for Hearing Impaired (800) 627-3539
PHYSICAL THERAPIST FACT SHEET
PHYSICAL THERAPY BOARD
The Physical Therapy Board is appointed by the Governor to act on issues regarding physical
therapist licensure standards, enforcement of laws and complaint review. The Board is composed of
five physical therapists, one licensed physician, two physical therapist assistant, and three public
members.
TITLE PROTECTION
Nonlicensed individuals are prohibited from using the title "Physical Therapist," "Physiotherapist,"
"Physical Therapy Technician," "Registered Physical Therapist," "Licensed Physical Therapist,"
"P.T.," " P.T.T.," "R.P.T.," "L.P.T." or any other words, letters, abbreviations, or insignia indicating or
implying that the individual is licensed by the state. Nonlicensed individuals holding themselves out
as a physical therapist shall be subject to criminal prosecution for the unauthorized practice.
LICENSURE REQUIREMENTS
US/Canadian Graduates. To establish eligibility for licensure, an applicant must have successfully
completed an accredited physical therapy educational program and have passed an approved
licensing exam.
DELEGATION OF DUTIES
The PT is responsible for all procedures or tasks delegated to a PTA or PT Aide.
PT Assistant. The PT may delegate patient treatment procedures to a qualified PT Assistant (PTA)
except: patient evaluation, treatment planning, initial treatment, change of treatment, and initial or
final documentation. The PT must provide on-site observation of the treatment and documentation of
its appropriateness at least every six treatment sessions. A PT may supervise no more than two
PTAs at any time. The PT is not required to be onsite, but must be easily available by
telecommunication.
PT Aide. A PT may assign selected treatment procedures to a PT Aide. The PT must observe the
patient's status before and after the treatment. All tasks must be performed under the direct
supervision of a PT who is readily available for advice, instruction, or immediate assistance.
CONTINUING EDUCATION
Each licensed physical therapist must complete at least 20 contact hours of continuing education
credit every two years as a condition of licensure renewal. Newly licensed physical therapists
commence their two year cycle on January 1 immediately following the date licensure was granted,
and continuing education credits may be accrued during the first partial year in addition to the two full
years of licensure. Licensees are required to attest to completion of continuing education by
reporting to the Board at renewal time. Continuing education documentation must be retained by
each licensee in the event they are selected for an audit.
If any part of this Fact Sheet conflicts with Minnesota rules or laws, the rules or laws take precedence. It is your responsibility to understand and
comply with the regulations. Please call if you have any questions.
PRACTICE REQUIREMENT
Physical therapists must practice the equivalent of eight full weeks (320 hours) during the past five
years in order to be issued a license, renew, reinstate following a lapse in licensure, or return to
active licensure status from inactive status. Alternatively, physical therapists may choose to retake
and pass the National Physical Therapy Exam or complete no less than eight weeks of Board
approved supervised clinical practice. The supervised clinical practice length and site must be pre-
approved by the Board.
RENEWAL CYCLE
Licensure must be renewed annually before January 1 of each year. Renewal reminders are sent
approximately 45 days prior to expiration. It is the physical therapist's responsibility to keep the
Board advised of their current address with written notification within 30 days of any address change.
The Board will mail the renewal reminder to the address on file. Failure to receive the renewal
reminder does not relieve the physical therapist of his or her renewal obligation.
NPTE REGISTRATION INFORMATION
2021 PT Test Dates:
1. Have all required documents to the Board of Physical Therapy by the deadline listed above.
a. Two recommendation forms
b. Certification of Education
c. Completed application and affidavit of applicant
d. Name change (if applicable)
e. Legal documents (if applicable)
f. Any other information requested by the Board
2. The Board will approve all qualified applicants to test as soon we possible. Applicants will be able
to view approval from the Aboard via the Online login: https://phy.hlb.state.mn.us/#/login
3. Instructions for scheduling the exam with Prometric Test Center are in the FSBPT Candidate
Handbook (fsbpt.org)
TEMPORARY PERMITS FOR NEW PT GRADUATES
Temporary permits to practice physical therapy are available for new graduates before they have
taken the NPTE exam after the following steps have been completed:
1. Board has received completed application and all supported documentation.
2. Board has also approved applicant to take NPTE exam and has notified FSBPT. (Reminder
applicants must also registered separately for exam with FSBPT see www.fsbpt.org)
3. FSBPT has notified applicant with “Authorization to Test” letter
4. Applicant has scheduled an exam date with Prometric Testing Centers.
Test Date
Applicant FSBPT
Registration Deadline
Deadline for approval from
MN Board of PT for
required Information
January 26, 2021 December 22, 2020 December 28, 2020
April 28, 2021 March 24, 2021 March 26, 2021
July 27 & 28, 2021 June 22, 2021 June 25, 2021
October 27, 2021 September 22, 2021 September 24, 2021
5. Temporary permit form and fee have been received by the Board.
6. Applicant has notified Board of test confirmation number from Prometric and exam date.
Please note: Temporary permit issue and expiration dates are related to the exam date you select.
See chart “Temporary Permits for PT New Graduates in 2021.”
This permit allows applicants to practice physical therapy under direct, immediate, and on premise
supervision. It may be granted once and cannot be renewed.
BOARD MEETINGS AND DEADLINES
It is your responsibility to make sure your file is complete; i.e. competed application, exam scores,
and documentation have been received by the Board. The Board will not review applicants with
incomplete files. Appplicants who answer “yes” to a question on their application or provide
incomplete information are reviewed by the Licensure Committee at a PT Board meeting*. Wall and
wallet certificates will be issued after the Board meetings.
Passing score on fixed testing date:
ALL PHYSICAL THERAPY LICENSES EXPIRE ON DECEMBER 31
ST
OF EACH YEAR
Questions
If you have specific questions about the application process, please call 612-627-5406 or email
physical.therapy@state.mn.us.
Address all written correspondence to:
MN Board of Physical Therapy
2829 University Ave SE, Suite 420
Minneapolis, MN 55414-3664
NOTE
It is the applicant’s responsibility to provide written notification to the Board within 30 days of an
address change.
All physical therapists practicing in Minnesota have a legal responsibility to comply with the
Minnesota Physical Therapy Practice Act:
Minnesota Statutes 148.65-148.78
Minnesota Rules 5601.0100-5601.3200
Found at: https://mn.gov/boards/physical-therapy/statutesandrules/
FIXED DATE TESTING *PT BOARD MEETING or REVIEW DATE
January 26, 2021
February 11 or 25, 2021
March 11* or 15, 2021
April 28, 2021
May 13* or 27, 2021
June 10 or 24, 2021
July 8 or 22, 2021
August 12*, 2021
July 27 & 28, 2021
August 12* or 26, 2021
September 16* or 30, 2021
October 27, 2021 November 4* or 18, 2021
Temporary Permits for PT New Graduates in 2021
Temp Permit Issued Exam Date
Temp Permit
Expiration: Next
Exam Date
Temp Permit
Expiration: 90 Days
Temp Permit
Expiration: Next
Board Meeting
Temp Permit
Expiration: If the
application doesn’t
take scheduled exam
License Issue Date with Passing
Score on Exam & Final Transcript
Dec 2020 March 11, 2021 1/26/21 N/A April 26, 2021* OR March 11, 2021* January 26, 2021
Feb 11 or 25, 2021
**March 12 or March 25, 2021
Dec 2020January 26, 2021 4/28/21 1/26/21 N/A N/A N/A **May 14 or 27, 2021
January 27 May 13, 2021 4/28/21 N/A July 27, 2021* OR May 13, 2021* April 28, 2021
**May 14 or 27, 2021
June 10 or 24, 2021 or
July 8 or 22, 2021
January 27 April 28, 2021
7/27/21 &
7/28/21
4/28/21 N/A N/A N/A **Aug 13 or Aug 26, 2021
April 29 August 12, 2021
7/27/21 &
7/28/21
N/A Oct 25, 2021* OR August 12, 2021* July 28, 2021 **Aug 13 or Aug 26, 2021
April 29 July 28, 2021 10/27/21 7/28/21 N/A N/A N/A **Nov 5 or Nov 18, 2021
July 29 Nov 4, 2021 10/27/21 N/A Jan 25, 2022* OR Nov 4, 2021* Oct 27, 2021 **Nov 5 or Nov 18, 2021
*The Temporary Permit Expiration Date is whichever date occurs first. Board meetings are scheduled however there is always a remote
possibility of a cancellation or postponement of the meeting. NOTE: If the applicant fails the exam then the Temporary Permit expiration date will
be changed by operation of statute when the application is reviewed at the next Board meeting. Shaded rows show the uninterrupted temporary
permit to licensure routes, assuming the application achieves a passing score on the NPTE.
**PT Board meeting date. Applicants who answer yesto a question on their application or provide incomplete information must be
reviewed by the Licensure Committee and Board at a PT Board meeting.
The practice of physical therapy by an applicant after the Temporary Permit expiration date has been changed by operation of
statute will be considered to be unlicensed practice and subject to possible disciplinary action under MS 148.75 (a)(1), (18), and 148.76,
Subd. 1, (1).
148.71 TEMPORARY PERMITS.
Subdivision 1. [Repealed, 2007 c 123 s 137]
Subd. 2. Issuance. (a) The board may, upon completion of the application prescribed by the board and payment of a fee set by the board,
issue a temporary permit to practice physical therapy under supervision to an applicant for licensure as a physical therapist or physical therapist
assistant who meets the educational requirements of section 148.721 or 148.722 and qualified for admission to examination for licensing as a
physical therapist or physical therapist assistant. A temporary permit may be issued only once and cannot be renewed. It expires 90 days after the
next examination for licensing given by the board or on the date on which the board, after examination of the applicant, grants or denies the
applicant a license to practice, whichever occurs first. A temporary permit expires on the first day the board begins its next examination for license
after the permit is issued if the holder does not submit to examination on that date. The holder of a temporary permit to practice under supervision
may practice physical therapy as defined in section 148.65 if the entire practice is under the supervision of a person holding a valid license to
practice physical therapy in this state. The supervision shall be direct, immediate, and on premises.
(b) An applicant from another state who is licensed or otherwise registered in good standing as a physical therapist by that state and meets the
requirements for licensing under section 148.721 does not require supervision to practice physical therapy while holding a temporary permit in this
state. The temporary permit remains valid only until the meeting of the board at which the application for licensing is considered.
MINNESOTA BOARD OF PHYSICAL THERAPY
University Park Plaza • 2829 University Avenue SE • Suite 420 • Minneapolis, MN 55414-3245
Telephone (612) 627-5406 Fax (612) 627-5403 • http://mn.gov/boards/physical-therapy/
physical.therapy@state.mn.us • MN Relay Service for Hearing Impaired (800) 627-3539
Please thoroughly review these materials before submitting your application. Any processing fees
incurred are your responsibility. The Board reserves the right to reject any outdated applications
submitted.
LICENSURE REQUIREMENTS FOR NEW PT GRADUATES
(TAKING THE EXAM WITH MINNESOTA)
Please note: most forms to be filled out are contained in this document. The application form is a
separate process that should be completed online: https://mn.gov/boards/physical-
therapy/applicants/pt-ng.jsp and click “Online Application” to get started.
A completed application consists of:
Contents of Application:
1. Evidence satisfactory to the board that the applicant has met the educational requirements of
section 148.721 or 148.722 as demonstrated by a certified copy of a transcript. (The transcript
must be sent directly to the MN Board of PT office from the school)
2. Two recommendation forms submitted by two physical therapists registered or licensed to
practice physical therapy in the United States or Canada. (Choose two physical therapist
references from those listed on page 3 of your application to complete the recommendation
forms. They must be mailed to the Board office by the individual filling out the form)
3. A recent full faced photograph of the applicant attached to the application with the affidavit on
the form completed and notarized. (2x3 photograph printed on photo paper affixed)
4. A record of the applicant’s high school, college and board-approved physical therapy school
education listing the names, locations, dates of attendance and diplomas, degrees or
certificates awarded. (All time must be accounted for on the application from high school to
the date of application. During continuous years of education, period of three months or less
(summer break) need not be accounted for)
5. A record of postgraduate work and military service. (Notarized copy of military discharge
papers, if applicable)
6. If applicable, a listing of the United States jurisdictions, and countries in which the applicant is
currently licensed or registered, or has been in the past. (Please have each
jurisdiction/country verify your license/registration. All verifications must be sent directly from
the agency(ies) to the MN Board of PT office)
7. A record of disciplinary action taken on past complaints, refusal of licensure or registration, or
denial of examination eligibility by another state board or physical therapy society against the
applicant.
8. A record of the applicant’s personal use or administration of any controlled substances and
treatment for alcohol or drug abuse.
9. A record by the applicant of any disease, illness or injury that impairs the applicant’s ability to
practice physical therapy.
10. A record of any convictions for crimes related to the practice of physical therapy, felonies,
gross misdemeanors, and crimes involving moral turpitude.
11. A listing of any memberships in a physical therapy society.
12. The applicant’s name and address.
13. The applicant’s social security number, alien registration card number, or tax identification
number, whichever is applicable. (required for final licensure)
14. Completed copies of credentials verification forms provided by the Board. (if applicable)
15. Any other information judged necessary by the board to evaluate the applicant.**
16. A person who has previously practiced in another state shall submit the following additional
information with the license application for the five-year period of active practice preceding the
date of filing application in this state (Malpractice History Form)
a. The name and address of the person’s professional liability insurer in the other state
b. The number, date, and disposition of any malpractice settlement or award made to the
plaintiff relating to the quality of services provided
17. **Exam Scores (NPTE, ASI, or PES) must be sent directly from FSBPT to the Minnesota
Board of Physical Therapy indicating a passing score. (www.fsbpt.org)
18. **Physical Therapy Certificate of Education form. (From your school showing all didactics and
clinical training are complete, submitted directly to the Board office by the school)
19. **Notarized copy of legal document supporting a legal name change.
20. **Criminal Background Check. (fingerprint information packet email to you after you submit a
licensure application and fees)
APPLICATION FEES
Fees are non-refundable; even if it is determined that you are not eligible for licensure. Fees may
be paid via credit card with submission of an online application or personal check with
submission of a paper application. Check must be made payable to the MN Board of Physical
Therapy.
Permanent Licensure Application Fee: $100.00 (Required of all applicants)
This fee must be paid online.
Annual Licensure Fee: $60.00 (Required of all applicants)
This fee must be paid online.
Criminal Background Check Fee: $33.25 (Required of all applicants)
This fee must be paid online.
Exam Application Processing Fee: $50.00 (Required for new grads testing for a MN
license)
This fee must be paid online.
Temporary Permit Fee: $25.00 (optional)
This fee must be paid with a check or money order made payable to the MN Board of Physical
Therapy and sent with a completed Temporary Permit application form. Form and Fee may be
submitted at any time during the application process. Fee is non-refundable.
IMPORTANT NOTICE REGARDING PEAT AND NPTE
New graduate applicants need to be VERY CAREFUL about what study materials they use and
share. FSBPT will continue to aggressively penalize those who share copyrighted questions from
PEAT or the NPTE. Pleading ignorance of the source (“I didn’t know they were real PEAT or
NPTE test questions”) will not sway the Federation to mitigate those penalties.
AFFIDAVIT OF APPLICANT: PT
State (where notarized): County (where notarized):
I, _ _ , swear that I am the person described and
identified; that I have not engaged in any of the acts prohibited by the statutes of Minnesota.
I hereby authorize all educational institutions, hospitals, medical institutions or organizations, clinics, my references,
personal physicians, employers (past and present), business and professional associates (past and present), all
governmental agencies and instrumentalities (local, state, federal or foreign) to release to this licensing Board any
information, files, or records including (but not limited to) transcripts, medical records, personnel files, and any information,
favorable or otherwise, the Board may require for its evaluation of my professional, ethical, and physical qualifications for
licensure in Minnesota.
I hereby authorize the Board to verbally and/or in writing, release to and/or exchange with the Federation of State Boards
of Physical Therapy (FSBPT), data concerning me which has been classified as “private” under the Minnesota Government
Data Practices Act, Minnesota Statutes Section 13.41, subd. 2.
I hereby release, discharge, and exonerate the Board, its agents, and representatives, and any person furnishing information
to the Board from any and all liability of every nature and kind arising out of the furnishing of oral information or of documents,
records, or other information to the Board.
I have carefully read the questions in the foregoing application and have answered them completely, without reservations
of any kind, and I declare under penalty of perjury that my answers and all statements made by me herein are true and
correct. Should I furnish any false information in this application, I hereby agree that such act shall constitute cause for the
denial, suspension or revocation of my license to practice physical therapy in Minnesota. I understand that I am required to
update my application with pertinent information to cover the time period between date of application and date approved by
the Board.
Sworn to before me this _ day of , _.
Signature of Applicant
_ _
Signature of Notary Public
Notary Commission Expires: _
Affix Notary Seal or Stamp
CERTIFICATION OF IDENTIFICATION
Certification of Notary Public is required.
I certify that on the date set forth below, the individual named above did appear personally
before me and that I did identify this applicant by: (a) comparing his/her physical appearance
with the photograph on the identifying document presented by the applicant and with the
photograph affixed hereto, and (b) comparing the applicant’s signature made in my presence
on this form with the signature on his/her identifying document. Sworn to before me by the
applicant on this day of , .
Signature of Notary Public
Notary Commission Expires:
Paste a recent, front-view,
passport-type headshot
photo in this area.
The Board cannot accept
photocopied or
scanned images.
0315
Affix Notary Seal or Stamp
Signature of Applicant
PHYSICAL THERAPY CERTIFICATION OF EDUCATION
This form is for certification of Physical Therapy education for applicants applying for Minnesota
licensure and must be completed and mailed by the University/College to the Minnesota Board of
Physical Therapy. Any processing
fees are applicant’s responsibility. The applicant’s signature
authorizes release of information, favorable or otherwise, directly to this Board.
New Graduates: The Program Director may mail this certification not more than 13 weeks prior to
graduation. If the Program Director has any doubts about this applicant’s graduation status then this
form should not be completed or mailed prior to actual graduation.
Name: SSN:
Signature: Date:
..................................................................................................................................................
THE SCHOOL COMPLETES THE FOLLOWING INFORMATION
It is hereby certified that: (Name of Applicant)
Matriculated in: (Name of School)
Accredited physical therapy educational program located at: (Location of School)
This individual completed all didactic requirements and clinical internships successfully on:
OR
This individual was/will be granted a degree in physical therapy on:
Select type of degree received / will receive:
DPT MA MS MPT BA BS Certificate
Any disciplinary actions? Yes* No
Any derogatory information on file? Yes* No
School Seal**
Program Director/Dean/Registrar
Print Name:
Signature:
Date:
*Please attach letter of explanation.
Disciplinary action: formal action taken by the school/program, i.e., non-academic probation, dismissal, etc.
Derogatory information: behavior that may reveal a lack of professionalism as a potential threat to public safety.
**If there is no school seal, attach letter of explanation on letterhead.
PHYSICAL THERAPY RECOMMENDATION FORM
Two recommendation forms are required. Select two of the references (physical therapists) listed on
your application to complete and submit this form.
The individual providing this reference must mail this form via USPS directly to the Board at the
above address.
New Graduates: Physical therapy professors or
clinical affiliation supervisors may be used.
RECOMMENDATION FOR:
(Applicant Name)
1. How long have you known the applicant?
2. What has been the nature of your relationship with the applicant?
3. How would you characterize the moral and professional conduct of the applicant?
4. Would you recommend the applicant for approval for licensure as a physical therapist?
Yes No
5. Additional comments:
COMPLETED BY
Name: Title:
Professional Designation: Phone #:
Address:
Email address:
Signature: Date:
Faxed or Emailed documents will not be accepted
PHYSICAL THERAPY RECOMMENDATION FORM
Two recommendation forms are required. Select two of the references (physical therapists) listed on
your application to complete and submit this form.
The individual providing this reference must mail this form via USPS directly to the Board at the
above address.
New Graduates: Physical therapy professors or clinical affiliation supervisors may be used.
RECOMMENDATION FOR:
(Applicant Name)
1. How long have you known the applicant?
2. What has been the nature of your relationship with the applicant?
3. How would you characterize the moral and professional conduct of the applicant?
4. Would you recommend the applicant for approval for licensure as a physical therapist?
Yes No
5. Additional comments:
COMPLETED BY
Name: Title:
Professional Designation: Phone #:
Address:
Email address:
Signature: Date:
Faxed or Emailed documents will not be accepted
PHYSICAL THERAPY
TEMPORARY PERMIT REQUEST FORM
This form and the $25.00 fee are required to apply for a temporary permit.
I have read Minnesota Statutes 148.71 regarding the use of the temporary permit and hereby
agree to abide by Minnesota Statutes and Rules governing physical therapists.
Applicant’s Name (please print)
Signature of Applicant
List name(s) of supervising physical therapist(s) and license number(s) (for new grads only)
Professional address at which the temporary permit will be used
(attach an additional sheet if more than one location)
Hospital/Clinic:
Department:
Address:
Professional telephone number(s): (Include area code)
Anticipated date of commencing practice:
Address you wish to have the temporary permit mailed to:
NOTE: It is your responsibility to immediately notify the Board if you wish to add or change the
supervisor(s) and/or pract
ice site(s) and receive Board approval prior to working under a new supervisor
or at a new practice site.