Physical Therapist Application

We are pleased to learn of your interest in the Lake Land College Physical Therapist Assistant Program. To be considered a candidate, you must have your application file completed by March 1 for consideration for the fall term. Incomplete files will not be considered. It is the applicant's responsibility to:

  • Complete the Lake Land College admission application and place on file in the Admissions Office, as a Career Track – Physical Therapist Assistant major (Major code – AAS.PTA.TRK).
  • Complete the information on each tab of the Physical Therapist Assistant application form below.
  • Take the College assessment test – (reading, English, math). Contact the Learning Assistance Center at 217-234-5301 to set up a time for the assessment test. (PTA applicants are eligible to take the assessment tests up to three times.)
  • Submit official high school and/or other college transcript(s) to the Admissions Office to show completion of the one (1) Biology prerequisite course (one year high school biology/zoology/A & P, or Lake Land College Basic Anatomy and Physiology (BIO050) or Bio Science I (BIO100) or Human Anatomy and Physiology I (BIO225) or Human Anatomy and Physiology II (BIO226) or equivalent) with a "C" or better within the past five (5) years. Contact the Admissions Office at 217-234-5434 with questions regarding transcripts on file.
  • Additional documents will be required once accepted into the program: a.) documentation of PT observation or experience hours b.) health exam and immunization records c.) CPR certification
Once again, it is your responsibility to see that your file is completed before March 1 of the year that you are applying for. If you have any further questions about the program, please call us at 217-540-3535 or 217-540-3551. We wish you well in your academic endeavors.

Physical Therapist Assistant Program Application

Personal Information


I have attended college
I have not attended college
Colleges (if applicable):
College Name:
Degree Earned:

College Name:
Degree Earned:

College Name:
Degree Earned:

College Name:
Degree Earned:

Declaration of Intent


  • The completed application does not guarantee admission to the Program.
  • The Lake Land College PTA program is a regional program which includes Parkland, Danville, and Richland Community College students.
  • A felony conviction may preclude your being able to sit for the PTA licensure examination.
  • There is no waiting list from year to year. You must contact the PTA Secretary at the Kluthe Center to advance your file to the next year.
  • It is your responsibility to see that your file is complete before the March 1 deadline.
  • You will be asked to work on one another and expected to play the role of a patient during labs.  Hands on demonstrations are required by instructor/student and student/student.
  • You will be required to submit to a criminal background check prior to clinical affiliations. Some clinical sites are requiring drug testing prior to clinical affiliations as well.
  • COVID-19 Information:
    • Lake Land College has implemented requirements and procedures in accordance with the Governor's Executive Order mandating vaccination or weekly COVID-19 testing for all Illinois higher education personnel and students, the related Illinois Community College Board directives, and guidance from the CDC and IDPH. All students and employees are responsible for reviewing and following the requirements and procedures as presented on the College's Pandemic Response Safety Guidelines posted on the College website.
    • Currently, masks covering the nose and mouth are required indoors at all times for both vaccinated and unvaccinated individuals, except when the individual is alone in an enclosed office with the door closed. Individuals refusing to wear a mask appropriately indoors will be required to leave. Students and employees who have not submitted documentation confirming full vaccination are required to complete a COVID-19 test on campus weekly or submit weekly results of a third-party test (see website for information regarding submission of third-party test results). Individuals who have medical conditions or religious beliefs that preclude vaccination must test weekly. There is no exemption from weekly testing unless individuals are fully vaccinated. Compliance will be monitored and individuals who are not in compliance will be excluded from campus. Repeated non-compliance may result in withdrawal from in-person classes and disciplinary action.
    • The Allied Health Programs guidelines and expectations align with the requirements and procedures presented in the College's Pandemic Response Safety Guidelines. If the College updates the requirements and procedures, the Allied Health Programs will follow the new guidelines. If clinical partners impose requirements that are more restrictive, such as a vaccination mandate, the Allied Health Programs will follow the clinical partner's requirements. If a student refuses to comply with the clinical site's requirements, he/she will fail to meet clinical objectives and will therefore fail the course.


  • Student must maintain “C” or above in ALL course work once admitted to the Physical Therapist Assistant program and maintain a 2.0 GPA in the Program.
  • Student must progress with support and core courses which correspond to the curriculum model once admitted to the Program.
  • Student must keep all patient information confidential.
  • Student must maintain professional standards of health.
  • Student attendance in all classes, labs and clinical practicums is mandatory.
  • Student agrees to attend the clinical site as assigned by the ACCE and abide by its rules and regulations. Students will be assigned to a clinical facility according to the practicum focus, location, and availability. 
  • Student must provide transportation for clinical practicums.  Attempts will be made to keep travel distance no greater than 75 miles one way or 1.5 hours.


All students in the Lake Land College Physical Therapist Assistant program must be able to perform diverse, complex, and specific functions and skills. These qualifications are essential for successful completion of the requirements of the program and are necessary to ensure the health and safety of patients, peers, faculty and other healthcare providers. The essential qualifications include but are not limited to the following abilities:

  1. The ability to perform full range of motion of joints, fine motor movements of the hands, and the ability to stoop and bend.
  2. The ability to elicit information from patients by palpation, observation, auscultation, and other assessment methods.
  3. The ability to execute movements required to provide general care and treatment to patients in all health care settings including emergency treatment: e.g. transferring, lifting and turning patients, providing hygienic care, assisting patients in activities of daily living and providing cardiopulmonary resuscitation.
  4. The ability to lift and carry up to 50 pounds of weight on a daily basis.
  5. The ability to push or pull an occupied wheelchair, cart, or gurney on a daily basis.

  1. The ability to observe a patient accurately at a distance and close at hand. This requires functional use of the senses of vision and hearing.
  2. The ability to perceive the signs of disease and infection as manifested through physical examination, including from images of the body surfaces, palpable changes and auditory information.
  3. The ability to observe non-verbal communications when performing an assessment and intervention.
  4. The ability to use spoken and written English to communicate in a coherent manner and the ability to convey or exchange information with individuals of all professions and societal levels.
  5. The ability to process and communicate information on the patient's status with accuracy in a timely manner to members of the health care team.
  6. The ability to navigate through different computer softwares.

  1. The ability to utilize intellectual abilities, exercise good judgment, and promptly complete all responsibilities relevant to the diagnosis and care of patients and families.
  2. The ability to maintain mature, sensitive, and effective relationships with patients, students, faculty, staff and other professionals under all circumstances.
  3. The ability to recognize that one's own values, attitudes, beliefs, emotions, and experiences affect one's perceptions and relationships with others.
  4. The ability to function effectively under stress and to adapt to an environment that may change rapidly without warning and/or in unpredictable ways.
  5. The ability to learn and abide by professional standards of practice.
  6. The ability to engage in patient care delivery in all settings and be able to deliver care to all patient populations.
  7. The ability to respond in an emotionally controlled manner in learning situations and emergencies.

Students not adhering to these responsibilities and standards will be removed from the program. Program dismissal may be appealed by initiating the request through the Program Coordinator.

I have read and understand the above statements and accept the responsibilities and standards listed.