Post-Graduate Clinical Examination
This form is used to collect information from former regulated members of the College of Physiotherapists of Alberta who meet the eligibility criteria described below and wish to register for the Post-Graduate Clinical Examination.
Eligibility Criteria
Former regulated member registered on the College of Physiotherapists of Alberta's Provisional Register whose registration was cancelled January 1, 2017 or later, in accordance with Section 7(3) or 7(4) of the
Physical Therapists Profession Regulation
of Alberta, and
Has
NOT
exhausted their eligibility at the PCE Clinical Component administered by the Canadian Alliance of Physiotherapy Regulators (CAPR), or has
NOT
had three failed attempts or more at any combination of the Post-Graduate Clinical Examination, the PCE Clinical Component administered by CARP or any other Canadian physiotherapy regulators clinical evaluation for licensure.
Contact Information
Provide your legal name as indicated on your government issued identification.
*
First Name
Middle Name
Last Name
Provide the name found on your past College of Physiotherapists of Alberta registration record, if it is different from the legal name on your government issued identification.
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Past College of Physiotherapists of Alberta registration number.
*
Clinical Examinations or Evaluations
You must report all of your clinical competency examinations or evaluation attempts. This includes Alberta's Post-Graduate Clinical Examination, the PCE Clinical Component administered by the Canadian Alliance of Physiotherapy Regulators, and any other Canadian physiotherapy regulator's clinical evaluation for licensure.
List of Clinical Examination or Evaluation Attempts
*
Include name of organization administering the exam or evaluation and date of attempt/completion.
Declarations
I understand that:
*
False or misleading information may disqualify me from any approval granted to me.
I certify and declare that:
*
The information provided on this form is true.
Submission
Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Should be Empty: