The PTCAS form can be a little daunting for students applying to Physical Therapy school. However, it is important to understand what is required and how to fill out the form correctly in order to ensure your application is processed without any issues. In this blog post, we will discuss what information is required on the PTCAS form and provide some tips on how to complete it. Let's get started! Physical therapist assistant (PTA) programs are competitive, and the Physical Therapist Centralized Application Service (PTCAS) is one way that you can increase your chances of getting accepted into one of them. The PTCAS allows you to apply to multiple PT schools with just one application.
This quick guide will aid you to establish how long it'll require you to fill out ptcas form, the number of pages it's got, and some additional unique specifics of the form.
| Question | Answer |
|---|---|
| Form Name | Ptcas Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | observation hours log sheet, pt observation hours form, physical therapy observation hours form, ptcas observation form |
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
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 / |
|
|||||
|
|
Acute Care Hospital |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
Nursing Home/Skilled Nursing Facility/ Extended Care Facility |
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other Inpatient Facility |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
|
|
OUTPATIENT Settings: Facility has no overnight patients |
|
|
Hours Completed |
|
|
Hours Planned / |
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
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 |