Respiratory Care Practitioners Certification Program Apply for a New License - Application Instructions

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Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on official department forms.

The department shall not consider an application as officially submitted until the applicant pays the application fee and the fee clears the appropriate financial institution. The fee must accompany the application form.

The administrator shall send a notice listing the additional materials required to an applicant who does not complete the application in a timely manner. An application not completed within 30 days after the date of the notice shall be invalid.

Required application materials.

Application form

  • Educational record for regular certification. The department shall issue a regular certificate to an applicant who is currently credentialed by the National Board for Respiratory Care (NBRC) and nationally certified as a Certified Respiratory Therapist (CRT), a Certified Respiratory Therapy Technician (CRTT), or a Registered Respiratory Therapist (RRT), upon payment of the application fee, submission of the application forms and approval by the department, the department shall issue a regular certificate to a person who is currently credentialed by the National Board for Respiratory Care (NBRC).
  • Education record for temporary permit.
  • An expected graduation statement, including the expected date of graduation, signed by the respiratory care program director at the school.

Within 30 days following the expected date of graduation, the applicant must provide to the department:

  • a copy of the certificate of completion; or
  • a statement signed by the program director indicating that the applicant officially completed the program but the certificate is not available within 30 days of the completion date.

Examination results.

  • If the applicant is making application for a temporary permit, an examination score release form shall be signed allowing the department to obtain the applicant's examination results from the NBRC, or other agency administering the examination prescribed by the board.
  • If an applicant for a regular certificate is:
  • recognized as a certified respiratory therapist or registered respiratory therapist by the NBRC at the time of application, a photocopy of the certificate issued by NBRC shall be submitted in lieu of examination results; or
  • unable to show proof of successful completion or otherwise provide documentation acceptable to the department of the applicant's examination results, the application shall be disapproved.

Employment/experience documentation report form.

The forms can be obtained by clicking on the left hand side of the menu, titles "Applications/Forms".

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Last updated April 17, 2010
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    Respiratory Care Practitioners Certification Program