University of Vermont

Department of Rehabilitation and Movement Science

Doctor of Physical Therapy Program (D.P.T.)

Prerequisite Course Completion Form

The following form must be completed by all applicants to the (D.P.T.) Doctor of Physical Therapy Program. Failure to return this form will delay our processing and assessment of your application.

Please fill in the following information:

Date
First Name	Last Name
E-Mail Address	PTCAS ID #

Coursework for UVM Prerequisite Courses

UVM Prerequisite Courses	Course Name and #	College/University	Semester Completed or Planned	Grade in Course
Anatomy/physiology I Anatomy/physiology II Chemistry I w/lab Chemistry II w/lab Physics I w/lab Physics II w/lab Biology Exercise Physiology Psychology Statistics