Renewal Notice
Renewal Guidelines

Information and Instructions for Supervisors of Clinical Applications Performed by Individuals Applying for a Certificate Authorizing the Use of Physical Agent Modalities
Application for Physical Agent Modalities Certificate Part A
Application for Physical Agent Modalities Certificate Part B
Report of Required Professional Education in Physical Agent Modalities
Supervision Form

LISTS AND LABLES FOR ALL PROFESSIONS:

Lists

The Office of Licensed Allied Health Professionals provides lists for each profession. The cost of each list that is provided by e-mailed is $10.00 per profession and for a paper copy the cost is $15.00 per profession. Assistants are included in both the occupational therapy list and the physical therapy list. Send your written request to Office of licensed Allied Health Professionals, 2 Industrial Park Drive, Concord NH 03301, be sure to included your e-mail address if you are requesting the list be sent by e-mail. Include with your request a check in the appropriate amount made out to "Treasurer, State of NH".

Labels

If you are requesting labels the cost of the labels is $25.00 per profession and you provide the labels to be printed on. The labels you must provide are Avery 1" X 2 5/8" - Laser 5160. Please contact the office before sending in your request to determine how many labels you will need to provide.

Once your request is received at the Office of LIcensed Allied Health Professionals it takes approximately 1 week for lists and up to two weeks for labels.

VERIFICATION OF LICENSURE FOR ALL PROFESSIONS:

To obtain a letter of verification from the Office of Licensed Allied Health Professionals send a written request and a check in the amount of $15.00 made payable to "Treasurer, State of NH" to the Office of LIcensed Allied Health Professionals, 2 Industrial Park Drive, Concord NH 03301.

Once your request is received at the Office of LIcensed Allied Health Professionals it takes approximately 1 week to process.