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PTCAS Observation Hours Form Template

Streamline Your Physical Therapy Observation Hours Log

Gathering your PTCAS observation hours can feel overwhelming, but this form template is designed to simplify the process for you. Ideal for aspiring physical therapy students, it helps you track and organize your observation experiences efficiently. With this template, you can easily log hours, meet admissions requirements, and present your experience clearly, all while ensuring your documentation stays compliant with standard guidelines. Use this handy tool to stay organized and focused on your path to becoming a physical therapist.

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Applicant full name
Applicant email
Applicant phone
PTCAS ID (if available)
Facility or organization name
Department or unit
If Other setting, please specify
Site city and state
Setting type
Please Specify:
Supervisor full name
Professional credentials
PT
DPT
PTA
Other
Please Specify:
License number and state
Supervisor email
Supervisor phone
Relationship to applicant
Direct supervisor
Observed therapist
Volunteer coordinator
HR representative
Other
Please Specify:
Experience type
Paid employment
Volunteer
Observation/shadowing
Internship/Practicum
Other
Please Specify:
Patient care exposure
Direct patient care
Non-patient care
Combination of both
Not applicable
Start date
End date
Total hours completed
Average hours per week
Typical schedule or dates and hours log (optional)
Brief description of activities observed or performed
I authorize programs/PTCAS to contact the supervisor to verify my hours
Yes
No
Supervisor typed signature (full legal name)
Date signed by supervisor
I confirm the dates and total hours listed above are accurate to the best of my knowledge
Yes
No
Applicant typed signature (full legal name)
Date signed by applicant
I certify that the information provided in this form is true and complete
Yes
No
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Paper art illustration representing the PTCAS Observation Hours Form Template and its features for FormCreatorAI article

When to use this form

Use this form when you need to log and verify PT observation for your PTCAS application. It suits pre-PT students tracking hours across multiple sites and clinic coordinators who confirm a student's time. Record dates, setting (outpatient, inpatient, pediatrics), supervisor credentials, and total verified hours so you can enter accurate details in PTCAS. If you also track non-clinical service, organize those separately with the Community service hours tracking form. When you collect signatures or letters to confirm time, pair this form with a Volunteer verification form. For broader records outside PT, route extracurricular time through the Volunteer hours submission form to keep reporting clean.

Must Ask PTCAS Observation Hours Questions

  1. Which facility and care setting did you observe, and which patient populations did you see?

    This shows the breadth and relevance of your experience, from outpatient ortho to acute care. Admissions can compare settings across sites and judge variety.

  2. How many total hours did you complete at this site, and over what date range?

    Exact hours and dates prevent double counting and prove recency. Clear totals speed data entry and review.

  3. What is the supervising PT/PTA's name, credential, license state/number, and email or phone?

    Programs often verify with a licensed professional, so complete contact info reduces delays. If you need a signed confirmation, attach it or collect it with the Volunteer verification form.

  4. What were your typical duties during observation and the top three skills you learned?

    This context shows depth of exposure and reflection, not just hours. It helps reviewers assess readiness and professionalism.

  5. Did your supervisor approve the hours listed, and may programs contact them if needed?

    Explicit consent and approval strengthen credibility. It reduces back-and-forth during admissions.

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