Getting Started

Notarized Attestation Form

After you complete the application for the New York Credentials Verification, download and complete this form; attach a passport-size photo; have the signed form notarized; and mail to FCCPT.

Notarized Attestation Form

After you complete the application for the New York Credentials Verification, download and complete this form; attach a passport-size photo; have the signed form notarized; and mail to FCCPT.

New York No Licensure Form

Download, complete page 1 and mail or email to all foreign license/registration authorities where you hold licenses/registration. The licensure/registration authority is required to complete page 2 and send both pages of the form back to FCCPT with any supporting documents.

Academic Verification form

Download, complete and mail this form to all institutions of post-secondary (higher) education where you have completed coursework.

Clinical Internship Form

Download, complete, and mail it to your institution to report required information regarding the clinical internship completed in your physical therapy academic program.

Licensure Verification Form

If you require the Type 1 Review for the purpose of licensure only (not for immigration purposes), download, complete and upload this form to FCCPT.

New York Request for Academic Credentials Verification Form*

Download, complete page 1 and mail or email to all foreign post-secondary, higher education schools where you have completed coursework. The schools complete page 2 and send both pages with your documents to FCCPT.

Clinical Internship Form

Download, complete, and mail it to your institution to report required information regarding the clinical internship completed in your physical therapy academic program.

New York Request for Licensure Verification Form*

Download, complete page 1 and mail or email to all foreign license/registration authorities where you hold licenses/registration. The licensure/registration authority is required to complete page 2 and send both pages of the form back to FCCPT with any supporting documents.

If documents are not in English:

• Provide the original language document (sent by the issuing institution) and a certified English translation
• Translations must include the translator’s attestation (signed/stamped) confirming accuracy and translator qualifications
• Do not send pre-translated documents from third parties in place of official source documents. Translations supplement the originals.

TOEFL (Test of English as a Foreign Language) Scores

Send official scores if required by the service or a licensing board. FCCPT’s institution code is 8164 and the department is Undergraduate.

NPTE (National Physical Therapy Exam) Scores

If applicable for licensure processes. If you have taken and passed the NPTE, have your official NPTE scores transferred to FCCPT.

CLEP (College Level Examination Program) Score Reports

If you have taken and passed one or more CLEP exams, have scores reported to FCCPT. FCCPT’s institution code is 1364.

Post Graduate Clinical Experience Form

Download, complete and mail to your employer (or former employer) to report required information regarding your post-graduate work experience.

General FedEx Form (optional)

If you want FCCPT to use your FedEx account to send documents related to the Type 1 Review (Type 1 Certificate) or Educational Credentials Review, download and complete this form, and upload to FCCPT.

Cancelation of Service Form

Download, complete, and upload to FCCPT to cancel an open service.

Change of Service Form

Download, complete, and upload to FCCPT to change an open service to a different service.

Change of State Request Form

Download, complete, and upload to FCCPT to change the recipient of an open service to a different state/jurisdiction or other recipient.

Included Report Request Form

Download, complete, and upload to FCCPT to request a recipient for an included report (for applicants who previously selected “none at this time” for the included report).

Authorization to Release Information (Release of Information Form)*optional

Download, print, fill out completely, sign, and have your signature notarized. Mail the form directly to FCCPT. FCCPT will not release information to anyone other than the applicant without this form.

FCCPT Education Revision Form

Download, complete, and upload to FCCPT to add, remove, or correct information about institutions of higher education that you have attended.

FCCPT PT License Revision Form

Download, complete, and upload to FCCPT to add, remove, or correct information about your licenses to practice physical therapy.

FCCPT Re-Evaluation Statement Form

Download, complete and upload to FCCPT. List the reason for the re-evaluation request, additional courses completed, additional documents being sent and the source of the documents, and any other issue you would like FCCPT to consider. Verify which jurisdiction you want the re-evaluation to be sent. If you need extra space to include information you may attach additional pages.

FCCPT Personal Information Revision Form

Download, complete, and upload to FCCPT to add, change or correct personal information, such as name, country of birth, or date of birth, that you have previously submitted.

Secondary Education Documents

Only for countries where secondary credentials are part of the evaluation. We require secondary education documents to be sent directly to FCCPT by the external examination body and NOT the secondary school.

FCCPT evaluates only post-secondary education, as recognized in the country where you studied. Do not send secondary education documents to FCCPT unless specifically requested.