Ptcas Form – Fill Out and Use This PDF

Updated: Nov 10, 2026

The PTCAS (Physical Therapy Centralized Application Service) form is a crucial document for individuals aspiring to enter the field of physical therapy. This extra form allows for the verification of physical therapy observation hours, a requirement by some programs that necessitates a licensed PT's signature to confirm the applicant's hands-on experience. By clicking the button below, you can get started on filling out your PTCAS form, ensuring all your physical therapy experiences are accurately documented and verified for your future admissions cycle.

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Ptcas Form PDF Details

The pursuit of a career in physical therapy demands rigorous preparation, part of which involves accumulating relevant experience in various settings. For individuals targeting admission into physical therapy programs, the Physical Therapy Centralized Application Service (PTCAS) form plays a pivotal role in this process. Specifically designed for those who need to have their physical therapy observation hours verified by a licensed physical therapist, the Physical Therapy Observation Hours Verification Form is a crucial document. It requires detailed input from applicants regarding their experiences across different settings, including both inpatient and outpatient facilities. The form not only captures the duration and nature of these experiences—categorizing them as paid, volunteer, or both—but also the types of patient diagnoses and populations observed. Critical instructions guide both the applicant and the verifying physical therapist on how to accurately complete and submit the form. Additionally, the document offers a section for the physical therapist to endorse the applicant's potential as a healthcare provider. This endorsement can significantly influence admissions decisions, making the accurate and thorough completion of this form essential for prospective physical therapy students. This process underscores the importance of comprehensive and verifiable hands-on experience in the highly competitive field of physical therapy.

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 form, therapy observation form, paper form for physical therapy observation hours, ptcas observation hours verification form

How to Fill Out Physical Therapy Observation Hours Verification Form

Physical Therapy Observation Hours Verification Form at a glance

What it is: 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.

Who signs: The Signature of Physical Therapist line is signed by the physical therapist.

What to bring and attach to Physical Therapy Observation Hours Verification Form

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.

The PT does not need to sign the new (bar-coded) PTCAS verification form, if no changes.

A filled-in Physical Therapy Observation Hours Verification Form example: a PT verifies volunteer observation hours at a clinic

Physical Therapy Observation Hours Verification Form example filled out, example: a PT verifies volunteer observation hours at a clinic — Sam Sample, a physical therapy applicant, has a licensed PT verify observation hours on this extra form. The facility is an outpatient clinic and the 40 hours are all completed, so no hours are planned. The picture shows page 1 filled in, and every value in it is made up. The PTCAS ID# stays empty because the form says to leave your PTCAS ID number blank. The PT will not submit a reference, so Yes stays empty and No is marked. The experience is volunteer work, so Paid and Both stay empty. Only Free-standing PT or Hospital Clinic is checked in the settings group, so every inpatient box and every other outpatient box stays empty. Hours Planned / In-progress stays empty because none are planned. Only General Orthopedic (musculoskeletal) and Sports are checked in the patient diagnoses group, so the other populations stay empty. The PT highly recommends the applicant, so the other four recommendation boxes stay empty.

How to fill out Physical Therapy Observation Hours Verification Form, box by box

Name of Applicant and Name of Facility

Enter the Name of Applicant. Leave the PTCAS ID# blank.

Enter the Name of Facility.

Enter the Street Address for Facility.

Enter the City, State, Zip/ Postal Code and Country.

Name of Physical Therapist

Enter the Name of Physical Therapist.

Physical therapist: you must enter your PT licensure information, the PT License Number, the State of PT License and the PT Phone #.

Enter the PT Email. Mark Yes or No for PT Will Also Submit a Reference?

Type of Experience

For Type of Experience, mark Paid, Volunteer or Both. Enter the Start Date and the End Date.

PT Settings and Hours of Experience

Check and enter hours for all settings that apply to the applicant's experience in this facility.

Under INPATIENT Settings (facility generally admits patients overnight), enter Hours Completed and Hours Planned / In-progress for Acute Care Hospital, Rehabilitation/Sub-acute Rehabilitation, Nursing Home/Skilled Nursing Facility/ Extended Care Facility or Other Inpatient Facility.

Under OUTPATIENT Settings (facility has no overnight patients), enter Hours Completed and Hours Planned / In-progress for Free-standing PT or Hospital Clinic, School/Pre-school, Wellness/Prevention/Fitness, Industrial/Occupational Health, Home Health or Other Outpatient Facility.

Enter the TOTAL # OF HOURS COMPLETED FOR ALL SETTINGS.

PT Patient Diagnoses/Populations Observed

Check all that apply to the applicant'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.

The boxes are General Orthopedic (musculoskeletal), Neurologic (neuromuscular), Cardiovascular / Pulmonary, Integumentary (wound management), Geriatrics, Pediatrics, Sports, Aquatics, WoŵeŶ's Health and Other.

How you think this person would perform as a health care provider

Physical Therapist, 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

The physical therapist signs the Signature of Physical Therapist line and enters the Date next to it.

More rules for Physical Therapy Observation Hours Verification Form

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.

Before you go

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.

Common questions about Physical Therapy Observation Hours Verification Form

Where do I file it?

Print and attach the new (bar-coded) PTCAS verification form to this signed form. Send both forms in a single envelope to PTCAS.

Sources

[1] Physical Therapy Observation Hours VERIFICATION FORM: Extra Form (PTCAS), the served file; no edition is printed (the Official source link on this page).