CERTIFICATION OF PHYSICAL THERAPIST EDUCATION To be completed by applicant and forwarded to school where degree will be awarded. Please complete and return this form, along with an unofficial copy of the applicant’s transcripts, to the Division of Professions and Occupations. SECTION 1 – To be completed by Applicant This certifies that __________________________________________________________________________ is Full Name of Applicant
enrolled in _______________________________________________________________________________ in Full Name of School and Program
___________________________________________ since the __________ day of _______________, _________. Location of School
Day
Month
Year
SECTION 2 – To be completed by School President, Dean or Registrar This undersigned certifies that the applicant listed above has successfully completed the Physical Therapy program and that the applicant has or will be granted a degree on the __________ day of Day
_____________________, __________. Month
Year
Signed This ___________ day of ________________________________________, ____________________. Day
Month
Year
By___________________________________________________________________________________________ President / Dean / Registrar
1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800
Management Branch. Office of Licensing. Page 1 of 1. Certification of Physical Therapy Education.pdf. Certification of Physical Therapy Education.pdf. Open.
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Page 2 of 6. Olympian High School. Course Syllabus. Page 2. Instructor Phone. Room E-mail. Course Rationale: This course is intended to be an introductory course to a career in one of the various healthcare. professions. In this course students will
