KS Board of Healing Arts website
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Attention Acupuncturists, Athletic Trainers, Chiropractors, Physical Therapists, Physical Therapist Assistants, Physicians, Physician Assistants, Occupational Therapists, Occupational Therapy Assistants, Podiatrists, Radiologic Technologists, and Respiratory Therapists:
The Board has contracted with VeriDoc for expedited license verification to other state medical boards for the above mentioned professions. Verification is convenient and virtually instantaneous. To obtain verification of your Kansas license, go to Veridoc.org to use their secure site any time, day or night. If you have problems with the online verification process, call VeriDoc support at (701)319-6500 or email them at support@veridoc.org. The Board will implement this service for other professions as it becomes available.
Sports Waiver (S.W.)
Sports Waiver (S.W.)
Telemedicine Waiver (T.W.)
Telemedicine Waiver (T.W.)
Athletic Trainer (A.T.)
Athletic Trainer (A.T.)
- Initial Licensing Application (Online)
- Initial Licensing Application (Fillable PDF)
- Reinstatement Application
- Address Change Request Form
- Athletic Trainer Practice Protocol Form
- Athletic Trainer Practice Protocol Termination Form
- Athletic Trainer Federal Enclave Practice Protocol Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change for the Allied Health
- Designation/Type Change to Military for all Professions
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Corporate Practice of Medicine (CPM)
Corporate Practice of Medicine (CPM)
Independent Certified Nurse Midwife (CNM-I)
Independent Certified Nurse Midwife (CNM-I)
- Initial Licensing Application
- Renewal Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Fingerprint Instructions and Waiver Agreement
- Kansas Fingerprint Locations List (Please note: This list is not all inclusive. Additional locations may be available in your area.)
- Name Change Form
- Third Party Release Form
- Non-Kansas Verification Form
Contact Lens Distributor
Doctor of Chiropractic (D.C.)
Doctor of Chiropractic (D.C.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Fingerprint Instructions and Waiver Agreement
- Kansas Fingerprint Locations List (Please note: This list is not all inclusive. Additional locations may be available in your area.)
- Name Change Form
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change for the Healing Arts
- Designation/Type Change to Military for all Professions
- Unlicensed Rad Tech Data Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Doctor of Medicine and Surgery (M.D.)
Doctor of Medicine and Surgery (M.D.)
- On-line Uniform Application (for Physician Licensure only) (Through Federation of State Medical Boards)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Fingerprint Instructions and Waiver Agreement
- Kansas Fingerprint Locations List (Please note: This list is not all inclusive. Additional locations may be available in your area.)
- (Institutional) Initial Licensing Application
- (Institutional) Reinstatement Application
- Institutional License Certification of Employment
- (Limited Permit) Initial Licensing Application
- (Limited Permit) Reinstatement Application
- (Special Permit) Initial Licensing Application
- Name Change Form
- Notice of Termination of Supervision of a Physician Assistant Form
- (Post Graduate) Initial Licensing Application
- Termination of Postgraduate Program
- (Post Graduate Supplemental Permit Application) Initial Licensing Application
- Resident Active Initial License Application
- Resident Active Renewal Application
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change for the Healing Arts
- Designation/Type Change to Military for all Professions
- Unlicensed Rad Tech Data Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Doctor of Naturopathic Medicine (N.D.)
Doctor of Naturopathic Medicine (N.D.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change to Military for all Professions
- License Verification Request Form
- Non-Kansas Verification Form
Doctor of Osteopathic Medicine and Surgery (D.O.)
Doctor of Osteopathic Medicine and Surgery (D.O.)
- On-line Uniform Application (for Physician Licensure only) (Through Federation of State Medical Boards)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Fingerprint Instructions and Waiver Agreement
- Kansas Fingerprint Locations List (Please note: This list is not all inclusive. Additional locations may be available in your area.)
- (Institutional) Initial Licensing Application
- (Institutional) Reinstatement Application
- Institutional License Certification of Employment
- (Limited Permit) Initial Licensing Application
- (Limited Permit) Reinstatement Application
- (Special Permit) Initial Licensing Application
- Name Change Form
- Notice of Termination of Supervision of a Physician Assistant Form
- (Post Graduate) Initial Licensing Application
- Termination of Postgraduate Program
- (Post Graduate Supplemental Permit Application) Initial Licensing Application
- Resident Active Initial License Application
- Resident Active Renewal Application
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change for the Healing Arts
- Designation/Type Change to Military for all Professions
- Unlicensed Rad Tech Data Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Doctor of Podiatric Medicine (D.P.M.)
Doctor of Podiatric Medicine (D.P.M.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Name Change Form
- (Post Graduate) Initial Licensing Application
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change for the Healing Arts
- Designation/Type Change to Military for all Professions
- Unlicensed Rad Tech Data Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Licensed Acupuncturist (L.Ac.)
Licensed Acupuncturist (L.Ac.)
- Initial Licensing Application
- Third Party Release Form
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Designation/Type Change for the Allied Health
- Name Change Form
- Request for a Duplicate Certificate Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Occupational Therapist (O.T.)
Occupational Therapist (O.T.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- OT - OTA Termination of Supervision
- OT - OTA Supervision Agreement
- Third Party Release Form
- Request for a Duplicate Certificate Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Occupational Therapy Assistant (O.T.A.)
Occupational Therapy Assistant (O.T.A.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- OT - OTA Termination of Supervision
- OT - OTA Supervision Agreement
- Third Party Release Form
- Request for a Duplicate Certificate Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Physician Assistant (P.A.)
Physician Assistant (P.A.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Active Practice Request Form (Used to notify KSBHA of Physician Supervision of Physician Assistant)
- Letter of Completion
- Name Change Form
- Notice of Termination of Supervision of a Physician Assistant Form
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Designation/Type Change for the Allied Health
- Designation/Type Change of Military for all Professions
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Physical Therapist (P.T.)
Physical Therapist (P.T.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- PT - PTA Supervision
- PT - PTA Termination
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Special Testing Accommodations Request Form (Non-CAPTE Graduates Only)
- Designation/Type Change for the Allied Health
- Designation/Type Change of Military for all Professions
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
- Affidavit and Authorization
Physical Therapist Assistant (P.T.A.)
Physical Therapist Assistant (P.T.A.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- PT - PTA Supervision
- PT - PTA Termination
- Third Party Release Form
- Request for a Duplicate Certificate Form
- Special Testing Accommodations Request Form (Non-CAPTE Graduates Only)
- Designation/Type Change for the Allied Health
- Designation/Type Change of Military for all Professions
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
- Affidavit and Authorization
Radiologic Technologist (L.R.T.)
Radiologic Technologist (L.R.T.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- Third Party Release Form
- Request for a Duplicate Certificate Form
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
Respiratory Therapist (R.T.)
Respiratory Therapist (R.T.)
- Initial Licensing Application
- Reinstatement Application
- Address Change Request Form
- Credit/Debit Card Payment Authorization Form
- Letter of Completion
- Name Change Form
- Third Party Release Form
- Request for a Duplicate Certificate Form
- (Student) Initial Licensing Application
- Designation/Type Change to Military for all Professions
- License Verification Request Form
- Expedited Verification of Kansas License to Other State Medical Boards
- Non-Kansas Verification Form
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