Application for Special Licence under Cross Border Services MOU

The Memorandum of Understanding (MOU) agreement makes it easier for licenced physiotherapists who are registered in one Canadian jurisdiction to obtain certificate of registration to practice in additional jurisdictions in order to provide continuing care or physiotherapy services that are not otherwise available, whether the services are delivered in person or via tele-rehabilitation.

Applicants for a special licence under MOU must fill in and submit the form below, including uploading applicable document(s) - Proof of Professional Liability Insurance, and a Letter of Good Standing from present college.

Upon receipt the form information, document(s) and payment, we will review your application and you will be contacted shortly.

During the COVID-19 Pandemic, the usual $25 special license fee will be waived. Please complete and submit the form below. When directed to PayPal page, you can simply close out your browser.

If necessary, please contact us for more information.

Special License under Cross Border Services MOU — Application Form

Personal Information
  1. English French

Present Place of Employment

Intended Work Site
  1. Prince Edward Island

Physiotherapy Qualifications
  1. Yes No

Supporting Documents

  1. I declare the information given on this form to be correct and complete to the best of my knowledge.

Word Verification

Please type the characters you see / hear in the box below (case sensitive) to verify that you are a real person, rather then a program sending automated messages.