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KANSAS LICENSURE APPLICATION INSTRUCTIONS …
www.ksbha.orgKansas State Board of Healing Arts Uniform Application Instructions Last revised May 2016 Page 2 of 3 . The Uniform Application for Physician State Licensure (UA)
K.A.R. 100-76-3. Waiver of examination and …
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The are Willing to Serve on a Medical Malpractice ...
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APPLICATION FOR CHANGE OF DESIGNATION/TYPE
www.ksbha.orgapplication for change of designation/type Please enter required information, sign and date on the bottom of page 2. Print and mail with required documentation,
PHYSICIAN ASSISTANT'S RESPONSIBLE PHYSICIAN …
www.ksbha.orgPHYSICIAN ASSISTANT'S RESPONSIBLE PHYSICIAN and DRUG PRESCRIPTION PROTOCOL Please enter required information, including signatures and dates on page 2 and page 4.
APPLICATION FOR PHYSICAL THERAPY - KSBHA
www.ksbha.orgAPPLICATION FOR PHYSICAL THERAPY. Completion of this application form is necessary for consideration for licensure. Disclosure of this information is voluntary; however, ... the applicant pursued and completed all requirements for the program of a Physical Therapist or Physical Therapist Assistant according to the standards of accreditation ...
APPLICATION FOR ATHLETIC TRAINER - KSBHA
www.ksbha.orgAPPLICATION FOR ATHLETIC TRAINER 1. Indicate your full legal name. If your name is different from that shown on your documentation you must submit a copy of the legal document of name change. Full Name: first middle last suffix Other names used, including maiden name: 2. Include residence, mailing and e-mail address.
ATHLETIC TRAINER'S RESPONSIBLE PHYSICIAN and …
www.ksbha.orgATHLETIC TRAINER'S RESPONSIBLE PHYSICIAN and PROTOCOL Please enter required information, sign and date at the bottom of the page. Mail or fax form.
STATE VERIFICATION FORM for MD, DO, DC, DPM, PA, PT, …
www.ksbha.orgSTATE VERIFICATION FORM for MD, DO, DC, DPM, PA, PT, PTA, ND, LRT, RT, OT and OTA. Please enter required information, sign and date at the bottom. E-mail, mail or fax ...
KANSAS STATE BOARD
www.ksbha.org(d) “Board” means the state board of healing arts. (e) “Council” means the physical therapy advisory council. (f) “Dry needling” means a skilled intervention using a thin filiform needle to penetrate into or through the skin and stimulate underlying myofascial trigger points or muscular or …
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