What’s My Status

File Library

Welcome to the FCCPT File Library

Here you will find all forms for your FCCPT service in one place, available for easy download. Review the Submitting Documents page for details on document and form submission to FCCPT.

Documents for Type 1 Review, and Educational Credentials Review Services

Attestation Form for PT Credentials Evaluation: After you complete the application for Type 1 Review or Educational Credentials Review, download and complete this form; attach a passport-size photo; have the signed form notarized; and mail to FCCPT.

Request Type 1 For Licensure Only: If you require the Type 1 Review for the purpose of licensure only (not for immigration purposes), download, complete and fax this form to FCCPT.

Request for Verification of Physical Therapy License: Download, complete and mail this form to all licensing agencies to verify status of license.

Request for PT Academic Credential Verification: Download, complete and mail this form to all institutions of higher education where you have completed coursework.

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, California P1F/P1G Certificate) or Educational Credentials Review, download and complete this form, and fax to FCCPT.

Documents for New York Credentials Verification Service

Attestation Form for New York State Credentials Verification: 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 State Academic Credentials Verification Request Form (NY Request Form for Academic Credentials Verification): Download and complete this form for all foreign institutions of higher education where you have completed coursework, and mail to FCCPT. FCCPT will request documents.

New York State License/Registration Verification Request Form (NY Request Form for Licensure/Registration Verification): Download and complete this form for all foreign licensing/registration authorities, and mail to FCCPT. FCCPT will request license verification.

NYS Certification of License Registration Not Held (NY “No License” Form): If you do not have a license to practice physical therapy, download and complete this form, and mail or fax to FCCPT.

New York Verification FedEx Form *optional: If you want FCCPT to use your FedEx account to send request letters, download and complete this form, and fax to FCCPT. For each institution that you want FCCPT to use your FedEx account to send request letters to, you must fill out a separate FedEx Form.

Documents for Physical Therapist Assistant Educational Equivalency Review (PTA-EER) Service

Attestation Form for PTA Credentials Evaluation: After you complete the application for the PTA-EER, download and complete this form; attach a passport-size photo; have the signed form notarized; and mail to FCCPT.

Request for PTA Academic Credential Verification: Download and complete this form, and mail to all institutions of higher education where you have completed course work.

General FedEx Form *optional: If you want FCCPT to use your FedEx account to send documents related to the PTA-EER, download and complete this form, and fax to FCCPT.

Cancellation and Change of Service Forms

Cancellation of Service Form: Download, complete, and mail or fax to FCCPT to cancel an open service.

Change of Service Form: Download, complete, and mail or fax to FCCPT to change an open service to a different service.

Change of State Request Form: Download, complete, and mail or fax 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 mail or fax to FCCPT to request a recipient for an included report (for applicants who previously selected "none at this time" for the included report).

Miscellaneous Documents and Forms

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 Education Revision Form: Download, complete, and mail or fax 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 mail or fax to FCCPT to add, remove, or correct information about your licenses to practice physical therapy.

FCCPT Re-Evaluation Statement Form: Download and complete this form, and mail or fax 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 mail or fax to FCCPT to add, change or correct personal information, such as name, country of birth, or date of birth, that you have submitted.

FCCPT PLAN-Incremental Request Form: (Only for applicants who have completed an evaluation with another credentialing agency) Download, complete, and mail or fax to FCCPT to request PLAN-Incremental service and establish your FCCPT file.

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