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* MS – Speech-Language Pathology Doctor of Physical Therapy (Flex – Online/Weekend) Doctor of Physical Therapy (Residential) Doctor of Occupational Therapy (First Professional) Doctor of Occupational Therapy (Post Professional) Doctor of Occupational Therapy (Flex – Weekend/Online) Master of Occupational Therapy (Residential) Master of Occupational Therapy (Flex – Weekend/Online) MSN – Nurse Executive MSN – Nurse Educator MSN – Family Nurse Practitioner BSN to DNP BSN to DNP – Nurse Executive BSN to DNP – Family Nurse Practitioner MSN to DNP MSN – Psychiatric Mental Health Nurse Practitioner-Primary Care MSN – Adult Gerontology Nurse Practitioner
Preferred Campus* Miami, FL St. Augustine, FL Austin, TX Dallas, TX San Marcos, CA
Preferred Campus* Miami, FL St. Augustine, FL Austin, TX San Marcos, CA
Preferred Campus* Miami, FL St. Augustine, FL Austin, TX San Marcos, CA
Preferred Campus* St. Augustine, FL Austin, TX San Marcos, CA
Preferred Campus* Dallas, TX
Preferred Campus* Austin, TX Dallas, TX
Hidden
Preferred Campus*
Distance
2nd Choice Campus Miami, FL Austin, TX San Marcos, CA All Campuses
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 Miami, FL Austin, TX St. Augustine, FL All Campuses
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 Miami, FL San Marcos, CA St. Augustine, FL All Campuses
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 Austin, TX San Marcos, CA St. Augustine, FL All Campuses
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 Miami, FL Austin, TX San Marcos, CA All Campuses
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 Miami, FL Austin, TX St. Augustine, FL All Campuses
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 Miami, FL San Marcos, CA St. Augustine, FL All Campuses
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 San Marcos, CA Austin, TX St. Augustine, FL All Campuses
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.
2nd Choice Campus Austin, TX Miami, FL San Marcos, CA
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 Miami, FL St. Augustine, FL San Marcos, CA
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 Miami, FL St. Augustine, FL Austin, TX
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 San Marcos, CA St. Augustine, FL Austin, TX
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
Desired Start Date*
01/09/2023
Desired Start Date* 1/9/2023 5/8/2023 9/5/2023 1/8/2024 5/13/2024
Desired Start Date* 5/8/2023 9/5/2023 5/13/2024 9/9/2024
Desired Start Date* 1/9/2023 9/5/2023 1/8/2024 9/9/2024
Desired Start Date* 9/5/2023 9/9/2024
Interested in MOT Flex? 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? 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* Hidden
Billing country code
State* AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY PR VI AS GU MP Other
Mobile Phone*
Other Phone
Emergency Contact Information Emergency Contact Name* Emergency Contact Relationship*
Emergency Contact Address* Emergency Contact State* AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY PR VI AS GU MP Other
Emergency Contact Phone*
Other Background Information Birthdate* MM slash DD slash YYYY
Gender* Female Male
Marital Status* Single Married Widowed
US Citizen?* Country of Citizenship* Citizenship Status* US Citizen Resident Alien Non-Resident Alien
Social Security Number
Actively Serving in Military?* Military Branch* Army Navy Air Force Marine Corp Coast Guard National Guard
Receiving US Military Veteran’s Benefits?* Have you ever been an OTA?* Have you ever been an PTA?* Are you Hispanic or Latino?* What is your race?* Check all that apply.
Highest Degree Earned?* BA-Bachelor of Arts BA-Bachelor of Arts BOT-Bachelor of Occupational Therapy BPT-Bachelor of Physical Therapy BS-Bachelor of Science BA/BS – (Communications Disorders/Speech/Equivalent) BSC-Bachelor of Science DC-Doctor of Chiropractic DHS-Doctor of Health Science DIP-Diploma DPT-Doctor of Physical Therapy EDD-Doctor of Education JD-Juris Doctor MA-Master of Arts MBA-Master of Business Administration MD-Doctor of Medicine MED-Master of Education MHA-Master of Health Adm MHE-Master of Health Education MHS-Master of Health Science MOM-Master of Oriental Med MOT-Master of Occupational Therapy MPA-Master of Public Administration MPH-Master of Public Health MPT-Master of Physical Therapy MS-Master of Science MSC-Master of Science MSO-Master of Science in OT MSP-Master of Science in PT OTD-Doctor of Occupational Therapy PHD-Doctor of Philosophy
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