Supplemental Application Form for CAS Applicants - University of St. Augustine for Health Sciences

The supplemental application form below is for use by applicants completing their application via one of the Common Application Systems (CAS) including:
- PTCAS for Physical Therapy programs
- OTCAS for Occupational Therapy
- CSDCAS for Speech-Language Pathology
- NursingCAS for MSN & DNP programs
If you have any questions please contact your Enrollment Advisor directly or contact us via the website.
Program of Interest*
Preferred Campus*
Preferred Campus*
Preferred Campus*
2nd Choice Campus
The Doctor of Physical Therapy (DPT) program is also available at our Miami, FL, Austin, TX and San Marcos, CA campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Doctor of Physical Therapy (DPT) program is also available at our Austin, TX, Miami, FL and St. Augustine, FL campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Doctor of Physical Therapy (DPT) program is also available at our Miami, FL, St. Augustine, FL and San Marcos, CA campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Doctor of Physical Therapy (DPT) program is also available at our Austin, TX, St. Augustine, FL and San Marcos, CA campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Master of Occupational Therapy (MOT) program is also available at our Miami, FL, Austin, TX and San Marcos, CA campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Master of Occupational Therapy (MOT) program is also available at our Austin, TX, Miami, FL and St. Augustine, FL campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Master of Occupational Therapy (MOT) program is also available at our Miami, FL, San Marcos, CA and St. Augustine, FL campuses. Select a 2nd choice campus if you are open to another or all campuses.
2nd Choice Campus
The Master of Occupational Therapy (MOT) program is also available at our San Marcos, CA, Austin, TX and St. Augustine, FL campuses. Select a 2nd choice campus if you are open to another or all campuses.
Preferred Campus*
Preferred Campus*
Preferred Campus*
Preferred Campus*
2nd Choice Campus
The Flex Master of Occupational Therapy program is also available at our Austin, TX and Miami, FL campuses. Select a 2nd choice campus if you are open to being considered for additional campuses.
2nd Choice Campus
The Flex Master of Occupational Therapy (MOT) program is also available at our Miami, FL, San Marcos, CA and St. Augustine campuses. Select a 2nd choice campus if you are open to being considered for additional campuses.
2nd Choice Campus
The Flex Master of Occupational Therapy (MOT) program is also available at our Miami, FL, Austin, TX and St. Augustine campuses. Select a 2nd choice campus if you are open to being considered for additional campuses.
2nd Choice Campus
The Flex Master of Occupational Therapy (MOT) program is also available at our San Marcos,CA, Austin, TX and St. Augustine campuses. Select a 2nd choice campus if you are open to being considered for additional campuses.
Hidden
Preferred Campus*
Preferred Campus*
Hidden
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date*
Desired Start Date:*
Desired Start Date:*
Desired Start Date:*
Desired Start Date:*
Interested in MOT Flex?
- Yes, tell me more about MOT Flex (Online/Weekend)
The Master of Occupational Therapy (MOT) program is also offered in a convenient Flex format (Online + Weekend Labs on campus). Check here if you're interested in hearing more about the Flex MOT currently offered in Miami, Austin and St. Augustine.
Interested in DPT Flex?
- Yes, tell me more about DPT Flex (Online/Weekend)
The Doctor of Physical Therapy (DPT) program is also offered in a convenient Flex format (Online + Weekend Labs on campus). Check here if you're interested in hearing more about the Flex DPT currently offered in Austin, San Marcos and St. Augustine.
Personal Information
Note: Please use the same email address used in the relevant CAS application. Using a different email address may delay the processing of your application.
First Name*
Middle Name
Last Name*
Preferred First Name*
Former Last Name
Preferred Email Address*
Permanent Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mobile Phone*
Other Phone
Emergency Contact Information
Emergency Contact Name*
First Last
Emergency Contact Relationship*
Emergency Contact Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact Phone*
Other Background Information
Birthdate*
MM slash DD slash YYYY
Gender*
Marital Status*
US Citizen?*
- Yes
- No
Country of Citizenship*
Country
Citizenship Status*
Social Security Number
Actively Serving in Military?*
- Yes
- No
Military Branch*
Receiving US Military Veteran’s Benefits?*
- Yes
- No
Have you ever been an OTA?*
- Yes
- No
Have you ever been an PTA?*
- Yes
- No
Are you Hispanic or Latino?*
- Yes
- No
What is your race?*
- Native American or Alaska Native
- Black or African American
- Native Hawaiian or Other Pacific Islander
- Asian
- White
Check all that apply.
Highest Degree Earned?*
Untitled*
- I agree
By clicking the checkbox, I provide my express written consent for University of St. Augustine for Health Sciences to contact me via email, text, telephone, and prerecorded message regarding furthering my education. I understand that calls may be generated using automated technology. You may opt-out at any time. Please view our Privacy policy or Contact Us for more details.

Personal Information

Emergency Contact Information

Other Background Information

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