Apply for a limited respiratory therapist license

• Completed application
• Application fee amount of $150.00
• 2x2 passport style color photo
  • White or off-white background
• Official transcripts for all respiratory care programs/degrees accredited by CoARC. Transcripts must clearly state the program/degree.
  • The educational institution must send transcripts directly to the Board.
• Verification of Education Form (PDF) | (DOCX) signed by the Respiratory Care Program Director and stamped with the school seal.
  • Must show proof you have completed at least two semesters of the respiratory care program.
• A National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank Self-Query. To request a Self-Query, please contact the National Practitioner Data Bank. The Self-Query must be submitted to the Board without any modifications.
• Signed and notarized Criminal Offender Record Information (CORI) Acknowledgement Form (PDF) | (DOCX)

If applicable

• Official verification of licensure from any state or jurisdiction in which you now or have previously held any professional license.
  • The state or other jurisdictions must send verifications directly to the Board.
• If you answer "yes" to any of the Professional and Criminal History Questions:
  • Submit a personal statement explaining the circumstances.
  • Submit all supporting documentation (police reports, court documents, disciplinary consent agreements, etc.)

The address printed on your license is a public record that is available to anyone who requests it. If you are using your home address, you may wish to consider changing this to an office address. You may request address changes online at the board’s website, or you may get a form online to submit to the Board’s office.