Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 2150 - State Board of Registration for the Healing Arts
Chapter 3 - Licensing of Physical Therapists and Physical Therapist Assistants
Section 20 CSR 2150-3.020 - Application Forms- Physical Therapists

(1) The applicant is required to make application upon a form prepared by the board.

(2) No application will be considered unless fully and completely made out on the specified form, properly attested, and submitted with the required application fee.

(3) An applicant shall present with the application at least one (1) recent photograph in a size not larger than three and one-half inches by five inches (3 1/2" x 5").

(4) Applications shall be sent to the executive director of the State Board of Registration for the Healing Arts, PO Box 4, Jefferson City, MO 65102.

(5) The board shall charge each person applying for licensure to practice as a professional physical therapist, either by examination or reciprocity, an appropriate fee established by the board.

(6) In all instances where the board, by rule or in the application form, has provided that it will accept copies in lieu of an original document, the applicant shall provide copies notarized by a notary public to verify that those copies are true and correct copies of the original document. The board will not recognize foreign notaries. The board shall accept the notarization of a United States consul.

(7) An applicant may withdraw his/her application for licensure anytime prior to the board's vote on his/her candidacy for licensure. In the event that an applicant withdraws his/her application, the appropriate fee established by the board will be retained.

(8) In all instances where a signature of the applicant is required, this signature must be an original signature.