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RESPIRATORY THERAPY LICENSURE BOARD 

RESPIRATORY FORMS


You may download Applications and Forms for this Board from the links provide below or they may be obtained by contacting the Board.
Allied Health Licensing Manager: Claudia Lawson


PLEASE NOTE: Should your license/permit be issued to you on or before March 30, you will be required to renew by June 30 of that year. If you do not receive a license/permit until after that date, you will not be required to renew until June of the following year.

No practice is permitted prior to receipt of a license/permit number.  

Applicants are advised not to enter irrevocable contracts, purchase or sales agreements, on the assumption that licensure/permit will be granted.



Applications must be on current forms provided by the Board or they will be returned to the applicant.

RT Initial Licensure Application Forms:

     Application for Initial Licensure
     NBRC Certification Verification

RT Temporary Permit Application Forms (Non-Certified/Registered Applicants):
     Application for Temporary Permit

Current RT Students:
     RT Student Exemption Application

Polysomnography Technologist Permit Application Forms (RPSGT Applicants):
     Application for Technologist Permit

Polysomnography Technician Permit Application Forms (Non-Registered Applicants):
     Application for Technician Permit

Polysomnography Trainee Temporary Permit Application Forms (No polysomnography experience):
     Application for Trainee Temporary Permit


**Processing time for an application is dependent on the Applicant and proper submission of the application with the required documentation.


All applications for licensure are confidential, privileged, and exempt from disclosure. Applicants and licensees wishing Board staff to discuss such confidential and/or privileged information to another person or entity must submit a valid Authorization for Release of Information.