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Liaison

Other Information

Language Proficiency

Select your first language (the language of your birth). If you speak additional languages, click Add Another Language. Then, select the language(s) and the level of your proficiency in each.

Military Status

If you have US military experience, select your anticipated status at the time of enrollment from the drop-down. Select Not a member of the military if this does not apply.

If a member of the military, select your branch of the Armed Forces from the drop-down and indicate the dates of service.

Academic Infraction

Indicate whether you have ever been disciplined or placed on academic probation while attending an academic institution. If you select Yes, enter a brief explanation in the field provided. Include:

  1. A brief description of the incident
  2. Specific charge made
  3. Related dates
  4. Consequence
  5. A reflection on the incident and how the incident has impacted your life.

License Infraction

Indicate whether you have ever had any certification, registration, license, or clinical privileges revoked, suspended, or in any way restricted by an institution, state, or locality. If yes, enter an explanation in the spaces provided.

Note that once you submit your application, you can update License Infractions only if you submitted your application with an answer of No.

Academic Record

Indicate whether your academic record accurately reflects your capabilities. If you select No, describe why. Include any information that may assist the admissions committee in interpreting and evaluating your academic history or credentials.

Previous Physical Therapy Assistant Education

Indicate whether you previously matriculated into a professional physical therapy assistant degree program. If you select Yes, you must:

  • Enter the physical therapy assistant program in the field provided.
  • Indicate whether you are eligible to return to the physical therapy assistant program.
  • Enter the institution in the Colleges Attended section.
  • If the program is located in the United States or Canada, report all completed coursework in the Transcript Entry section and arrange for an official transcript to be sent to PTACAS.

Additionally, indicate whether you previously applied to or matriculated into a medical or health professional school. If you select Yes, indicate the health profession.

Education Interruption

Indicate if your education has ever been interrupted or adversely affected for reasons other than deficiencies in conduct or academic performance. If you select Yes, enter an explanation in the field provided.

Military Service Interruption

Indicate if your education has ever been interrupted because of military service. If you select Yes, enter an explanation in the space provided.

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