The following form includes several pages of information you'll be supplying to VSA for review in determining approval for a practitioner license. The application will ask for some personal and professional information from you, all of which will be kept strictly confidential.
Please fill out all of the questions thoroughly, as they will be used to determine your approval for licensure. After you've filled in the fields on each page, click Next in the bottom right hand corner of the page to continue to the next question. This form should take approximately 10-15 minutes to complete. At the end of the form, press SUBMIT and the form will be sent to VSA for review. If you do not press SUBMIT, we will not receive your application.
After submitting the form, you will receive an email from VSA within 4-5 business days detailing the next steps in the licensure process, including a link to complete a criminal background check.
Thank you in advance for applying to become a VSA Licensed Practitioner.
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