Respiratory Care Practitioners Certification Program Application-Forms

Obtain a copy of the following publications now, just click on your selection:

Respiratory Care Practitioner Application Packet

• Adobe Acrobat (.pdf) format, 50 KB
• MS Word format, 87 KB

Application to Upgrade Temporary Certification

• MS Word format,32 KB

Application for Advisory Committee Membership

• MSWord format, 40KB
• Adobe Acrobat format, 17 KB

Respiratory Care Practitioner Renewal Form

• Respiratory Care Practitioner Renewal Form (Acrobat format, 46 KB)

Respiratory Care Practitioner Temporary Permit Renewal Form

• Respiratory Care Practitioner Temporary Permit Renewal Form (Word, 57 KB)

Respiratory Care Practitioner Request to Reactivate Form

• Respiratory Care Practitioner Request to Reactivate Form (Word format, 68 KB)
• Respiratory Care Practitioner Request to Reactivate Form (Acrobat format, 42 KB)

• Respiratory Care Practitioner Inactive Status Form (MSWord format, 20 KB)
   
• Respiratory Care Practitioner Inactive Status Form (Adobe Acrobat format, 5 KB)

Respiratory Care Practitioner Out of State Certification/Registration Verification Form

• Respiratory Care Practitioner Out of State Certification/Registration Verification Form (Word format. 34 KB)
• Respiratory Care Practitioner Out of State Certification/Registration Verification Form (Adobe Acrobat format, 31 KB)

Online Application

• Click here to apply online for a Respiratory Care Practitioner Regular Certificate
• Click here to apply online for a Respiratory Care Practitioner Temporary Permit
  

To access documents in Adobe Acrobat format, you must download the Acrobat Reader software. Please see the DSHS file viewing page for more information and a link to the Adobe website.