Criminal History Record Check Instructions
(142 KB PDF)

Request Verification

An official licensee verification will be emailed from the North Dakota Board of Physical Therapy to the organization named in the form.

To complete the verification request form:

  • Login below
  • Provide name, address and email for recipient organization

While you are in the online form please do NOT use the back button in your browser. If at any time you wish to exit the online form, please click the "Exit" button located at the bottom of the page.


Please enter your information below to log into the online form. Contact the board if you have any questions.

If you have a 3 digit license number, add a preceding zero.