Forms

Computer keyboard with white keys and a large blue key labled "Status".

New Applicants: Please visit the Application Portal to submit an application for Licensure.

Existing Licensees: Please visit the Licensee Portal to submit your renewal, update your personal information, order a license verification, or download a copy of your wallet card and license.

A Change of Contact Information Form

Form

The online portal is temporarily unavailable while we transition to our new licensing system. Please complete the Change of Contact Information Form and submit the form via email to [email protected].

Application for Licensure

Form

The online portal is temporarily unavailable while we transition to our new licensing system. Please review the instructions for submitting your application, complete the Application for Licensure Form and submit the form when you make your payment online.

Application for Licensure - Universal Recognition

Form

The online portal is temporarily unavailable while we transition to our new licensing system. Please review the instructions for submitting your application, complete the Application for Licensure - Universal Recognition Form and submit the form when you make your payment online.

Complaint Against a Licensed Respiratory Therapist

Form

The online portal is temporarily unavailable while we transition to our new licensing system. Please complete the Complaint Against a Licensed Respiratory Therapist Form and submit the form via email to [email protected].

Name Change

Form

The online portal is temporarily unavailable while we transition to our new licensing system. Please complete the Name Change Form and submit the form when you make your payment online.

Renewal Application

Form

The online portal is temporarily unavailable while we transition to our new licensing system. Please review the instructions for submitting your application, complete the Renewal Application Form and submit the form when you make your payment online.