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Content Overview

The PTCAS form is a crucial component for aspiring physical therapists, serving as a gateway to admission into various programs across the country. This form requires applicants to document their physical therapy observation hours, which must be verified by a licensed physical therapist (PT). For those who need a PT's signature, an additional verification form is provided, specifically designed for this purpose. It’s essential to fill out the form accurately, including details such as the name of the facility, the PT’s license information, and the applicant's experiences. Applicants should note that any changes to their PT hours after the form is signed necessitate a new signature from the PT. In addition to documenting hours, the form also prompts the PT to evaluate the applicant’s potential as a healthcare provider, adding a layer of insight into the applicant's readiness for the profession. By adhering to the instructions carefully and ensuring all information is complete, applicants can streamline their application process and enhance their chances of securing a spot in a competitive physical therapy program.

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Physical Therapy Observation Hours

VERIFICATION FORM: Extra

Form is only intended for use by individuals who need a PT signature for a future admissions cycle Some programs require a licensed PT to verify your physical therapy experiences. If required, provide this completed form to the appropriate PT for signature. Type or neatly handwrite your information directly onto this form, leaving your PTCAS ID number blank. Once you are ready to apply via PTCAS, enter all of your PT experiences on the PTCAS application exactly as they appear on this signed form. Select paper verification type. Print and attach the new (bar-coded) PTCAS verification form to this signed form. The PT does not need to sign the new form, if no changes. Send both forms in a single envelope to PTCAS. NOTE: If there are any changes to your PT experience after this form is signed, a PT must sign a new form to verify your revised hours.

Name of Applicant: _______________________________________________________ PTCAS ID#:_______________________

Name of Facility: ___________________________________________________________________________________________

Street Address for Facility: ___________________________________________________________________________________

City: ___________________________________________

State: ___ ___

Zip/ Postal Code: ________________________

Country: ___________________________________________

 

Name of Physical Therapist: ________________________________________________________________________________

PT License Number: ____________________________ State of PT License: ___ ___ PT Phone #:______________________

Instructions to physical therapist: You must enter your PT licensure information above.

PT Email: ____________________________________________________ PT Will Also Submit a Reference?

Yes

No

Type of Experience:

Paid

Volunteer

Both Start Date: ___________________

End Date: ____________________

PT Settings and Hours of Experience: Check and enter hours for all settings that apply to applica t’s experience in this facility.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INPATIENT Settings: Facility generally admits patients overnight

 

 

Hours Completed

 

 

Hours Planned / In-progress

 

 

 

Acute Care Hospital

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rehabilitation/Sub-acute Rehabilitation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nursing Home/Skilled Nursing Facility/ Extended Care Facility

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Inpatient Facility

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OUTPATIENT Settings: Facility has no overnight patients

 

 

Hours Completed

 

 

Hours Planned / In-progress

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Free-standing PT or Hospital Clinic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

School/Pre-school

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wellness/Prevention/Fitness

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Industrial/Occupational Health

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home Health

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Outpatient Facility

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL # OF HOURS COMPLETED FOR ALL SETTING

 

 

 

 

 

 

 

 

PT Patient Diagnoses/Populations Observed: Check all below that apply to the applica t’s experience at this facility. If the applicant did not directly observe a PT with a particular patient population, do not check box, regardless of whether the facility provides related services.

General Orthopedic (musculoskeletal)

Pediatrics

Neurologic (neuromuscular)

Sports

Cardiovascular / Pulmonary

Aquatics

Integumentary (wound management)

Wo e ’s Health

Geriatrics

Other

Taking into consideration these characteristics, how do you think this person would perform as a health care provider?

I highly recommend this applicant as a health care provider.

I recommend this applicant as a health care provider.

I recommend this applicant as a health care provider, but with some reservations.

I am not able to recommend this applicant as a health care provider.

I do not have sufficient information about the applicant to respond to this question.

Signature of Physical Therapist

Date

Form Specifications

Fact Name Description
Purpose This form is used for verifying physical therapy observation hours for applicants applying to physical therapy programs.
PT Signature Requirement Some programs require a licensed physical therapist (PT) to sign this form to validate the applicant's physical therapy experiences.
Completion Instructions Applicants must fill out the form with their information, leaving the PTCAS ID number blank for later entry.
Submission Process Both the signed verification form and a new bar-coded PTCAS verification form must be sent together in a single envelope to PTCAS.
Changes to Experience If there are any changes to the PT experience after the form is signed, a new form must be completed and signed by a PT.
PT License Information The physical therapist must provide their license number and state of licensure on the form.
Experience Types Applicants can categorize their experiences as paid, volunteer, or both, depending on their involvement.
Patient Populations Applicants should check all relevant patient diagnoses or populations they observed during their experience at the facility.

Ptcas: Usage Guidelines

Completing the PTCAS form is a crucial step for those pursuing a career in physical therapy. The process involves gathering information about your physical therapy observation hours and obtaining verification from a licensed physical therapist. Follow the steps below to ensure that you fill out the form accurately and completely.

  1. Start by downloading the Physical Therapy Observation Hours Verification Form.
  2. Type or neatly handwrite your information in the designated fields, leaving the PTCAS ID number blank for now.
  3. Provide the name of the facility where you completed your observation hours.
  4. Fill in the street address, city, state, zip/postal code, and country of the facility.
  5. Enter the name of the physical therapist who supervised your experience.
  6. Write down the PT license number and the state where the PT is licensed.
  7. Include the PT's phone number and email address.
  8. Indicate whether the PT will also submit a reference by selecting "Yes" or "No."
  9. Specify the type of experience you had: paid, volunteer, or both.
  10. Fill in the start and end dates of your observation hours.
  11. Check the appropriate boxes for inpatient and outpatient settings where you gained experience, and enter the total hours completed for each setting.
  12. Check all applicable patient diagnoses or populations you observed during your experience.
  13. Choose how the physical therapist would recommend you as a health care provider by selecting one of the options provided.
  14. Finally, the physical therapist must sign and date the form to verify the information provided.

After completing the form, make sure to print and attach the new bar-coded PTCAS verification form to the signed document. Send both forms together in a single envelope to PTCAS. If there are any changes to your PT experience after the form is signed, remember that a new verification form must be signed by the PT to reflect those changes.

Your Questions, Answered

What is the purpose of the PTCAS form?

The PTCAS form, or Physical Therapist Centralized Application Service form, is designed to streamline the application process for prospective physical therapy students. It collects essential information about your educational background, observation hours, and experiences in the field. Some programs specifically require a licensed physical therapist to verify your observation hours, which is where the verification form comes into play. This ensures that all reported experiences are accurate and credible, enhancing the integrity of your application.

Who needs to fill out the Physical Therapy Observation Hours Verification Form?

This form is primarily for individuals applying to physical therapy programs that require verification of observation hours by a licensed physical therapist. If your chosen program mandates this verification, you will need to provide this completed form to the appropriate PT for their signature. It is crucial to follow these requirements to avoid any delays in your application process.

How should I complete the Physical Therapy Observation Hours Verification Form?

When filling out the form, you should type or neatly handwrite your personal information. Make sure to leave your PTCAS ID number blank, as this will be filled out later when you submit your application. After the physical therapist has signed the form, you will enter all your PT experiences on the PTCAS application, exactly as they appear on this signed document. Remember to select the paper verification type and attach the new PTCAS verification form to the signed form before sending both in a single envelope to PTCAS.

What happens if my physical therapy experiences change after the form is signed?

If there are any changes to your physical therapy experiences after the verification form has been signed, you will need to obtain a new signature from a licensed physical therapist. This is essential to ensure that all information provided to PTCAS is accurate and up-to-date. Failing to do so could result in discrepancies in your application, potentially affecting your admission prospects.

Can the physical therapist also submit a reference?

Yes, the physical therapist who verifies your observation hours can also submit a reference for your application. On the verification form, there is an option for the PT to indicate whether they will provide a reference. This can be beneficial, as a strong recommendation from a licensed professional can enhance your application and provide valuable insights into your abilities as a future healthcare provider.

What information does the verification form require from the physical therapist?

The verification form requires several key pieces of information from the physical therapist. They must provide their name, PT license number, state of licensure, and contact information. Additionally, the form asks the PT to detail the type of experience you had (paid, volunteer, or both), the start and end dates of your observation hours, and the settings in which you gained experience. This thorough documentation helps to validate your application and ensures that all reported hours are accounted for accurately.

Common mistakes

  1. Leaving the PTCAS ID number blank: When filling out the verification form, applicants often forget to leave the PTCAS ID number blank. This ID is crucial for linking the form to their application, so it's important to follow the instructions carefully.

  2. Not providing complete facility information: Some applicants fail to include all necessary details about the facility where they completed their observation hours. Incomplete information can lead to delays or issues with verification.

  3. Forgetting to specify the type of experience: Applicants sometimes neglect to indicate whether their experience was paid, volunteer, or both. This detail is essential for accurately representing their background and experience.

  4. Incorrectly reporting hours: It’s common for applicants to miscalculate or misreport the total hours completed for all settings. Double-checking these numbers can help avoid discrepancies later in the application process.

  5. Not checking the appropriate patient diagnoses: Applicants may check boxes for patient populations they did not directly observe. This mistake can misrepresent their experience and may affect their application negatively.

  6. Overlooking the need for a PT signature on changes: If there are any changes to the PT experience after the form is signed, a new signature is required. Failing to obtain this can lead to complications in the verification process.

  7. Sending forms separately: Some applicants mistakenly send the verification form and the PTCAS application separately. It is crucial to send both forms in a single envelope to ensure they are processed together.

Documents used along the form

When applying to physical therapy programs, several forms and documents complement the PTCAS application. Each of these documents serves a specific purpose in the admissions process. Below is a list of commonly required forms that applicants may encounter.

  • Letters of Recommendation: Most programs require applicants to submit letters from individuals who can speak to their qualifications and potential as a physical therapist. These letters typically come from academic professors, employers, or licensed physical therapists who have supervised the applicant.
  • Personal Statement: This document allows applicants to express their motivations for pursuing a career in physical therapy. It should highlight relevant experiences, personal insights, and future goals, providing admissions committees with a deeper understanding of the candidate.
  • Transcripts: Official transcripts from all post-secondary institutions attended are required. These documents provide a record of the applicant's academic performance and are essential for evaluating their readiness for graduate-level coursework.
  • Resume or Curriculum Vitae (CV): A resume or CV outlines the applicant's educational background, work experience, volunteer activities, and relevant skills. This document helps to present a comprehensive view of the applicant's qualifications and experiences in the field of physical therapy.

Each of these documents plays a vital role in showcasing the applicant's readiness and commitment to the field of physical therapy. Ensure that all forms are completed accurately and submitted on time to enhance your application.

Similar forms

The PTCAS form, specifically the Physical Therapy Observation Hours Verification Form, shares similarities with several other important documents used in the healthcare and educational fields. Below are five documents that are comparable to the PTCAS form, highlighting their common features:

  • Clinical Experience Verification Form: Like the PTCAS form, this document is used to confirm an applicant's clinical hours and experiences. It requires signatures from licensed professionals to validate the applicant's hands-on training in a healthcare setting.
  • Internship Verification Form: This form serves a similar purpose by documenting the hours and nature of an internship. It often needs a supervisor's signature to confirm the applicant's participation and performance during their internship period.
  • Letter of Recommendation: While not a form per se, this document often accompanies applications and requires a professional's endorsement of the applicant's skills and experiences. It can enhance the credibility of the applicant's claims about their qualifications.
  • Residency Verification Form: Used in medical fields, this form verifies the completion of residency training. It includes details about the residency program and requires signatures from program directors, similar to the PTCAS verification process.
  • Professional Certification Verification Form: This document is utilized to confirm that an individual has completed the necessary training and has met the requirements for professional certification. It often includes a signature from a certifying body, much like the PTCAS form requires a PT's signature.

Dos and Don'ts

When filling out the PTCAS form, it’s important to follow certain guidelines. Here are four things you should and shouldn’t do:

  • Do type or neatly handwrite your information directly onto the form.
  • Do leave your PTCAS ID number blank when submitting the form for PT signature.
  • Don’t forget to enter all of your PT experiences on the PTCAS application as they appear on the signed form.
  • Don’t send the forms separately; make sure to send both forms in a single envelope to PTCAS.

Misconceptions

  • Misconception 1: The PTCAS form is only for current applicants.
  • This is incorrect. The form can also be utilized by individuals preparing for future admissions cycles. It allows for the verification of physical therapy experiences even before the application process begins.

  • Misconception 2: A PT signature is optional for all applicants.
  • In reality, some programs explicitly require a licensed physical therapist to verify the applicant's physical therapy experiences. Failing to provide this verification could jeopardize the application.

  • Misconception 3: Changes to PT experiences do not require additional documentation.
  • This is a misunderstanding. If there are any modifications to the PT experience after the form has been signed, a new verification form must be completed and signed by a PT to validate the updated hours.

  • Misconception 4: The PTCAS ID number must be filled out on the verification form.
  • This is not true. Applicants should leave the PTCAS ID number blank when submitting the verification form to the physical therapist. It is only required when entering experiences on the actual PTCAS application.

  • Misconception 5: The PT needs to sign every form submitted to PTCAS.
  • This is misleading. If there are no changes to the applicant's experiences, the physical therapist does not need to sign the new bar-coded PTCAS verification form. Only the original verification form requires a signature.

Key takeaways

When preparing to fill out and submit the PTCAS form, keep the following key takeaways in mind:

  • Verification Requirement: Some programs require a licensed physical therapist (PT) to verify your physical therapy experiences. Ensure you understand if this is necessary for your application.
  • Accurate Information: Fill out the form carefully. Type or neatly handwrite your information, leaving the PTCAS ID number blank until you are ready to apply.
  • Attach Required Documents: When submitting your signed form, include the new bar-coded PTCAS verification form. The PT does not need to sign this new form if there are no changes to your experience.
  • Changes in Experience: If there are any modifications to your physical therapy experience after the initial form is signed, a new verification form must be completed and signed by a PT.
  • Complete Details: Ensure that all sections of the form, including the name of the facility, PT license number, and hours of experience, are fully completed to avoid delays in processing your application.

By following these guidelines, you can help ensure a smoother application process. Taking the time to accurately complete the PTCAS form can significantly impact your admission prospects.