Respiratory Care Student Permit

Student Permits are issued to individuals who are currently enrolled in a respiratory care program and are a student in good standing. Student permit holders may only perform respiratory care procedures that have been part of a course the individual has successfully completed in the respiratory care program and for which the successful completion has been documented. The procedures permitted may be performed only on adult patients who are not critical care patients and under the proximate supervision of a practitioner.

Apply Online Now!

Go toMyLicense.IN.gov and you will either need to create or login to your Access Indiana, single sign-on account. You will complete the online application and submit payment with a credit or debit card. Please allow 48 business hours for your application to be received and reviewed. You will be contacted by a customer service representative with details of what additional documentation is required to complete your application.

Application Instructions

• Completed Application: Applications may be submitted online at MyLicense.IN.gov or completed by paper and mailed to our office. If you have ever held a license as a Respiratory Care Practitioner Student permit and wish to practice at another location, you will need to complete a new application for each location you wish to practice.
• Application fee of $25.00: Pay by credit or debit card for applications submitted online at MyLicense.IN.gov. If applying by paper/mail make checks or money orders payable to Indiana Professional Licensing Agency.  All application fees are nonrefundable.
• Name Change Documentation: Documentation of any legal name change if your name differs from that on any of your documents. Documentation may include a copy of your marriage certificate or divorce decree.
• Positive Response Documentation: If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
• Verification of Licensure: Verification of any registration/license/certification to practice any health related occupation in another state or territory.  Verifications must be submitted directly from the state of issuance.

The Fair Information Practice Act:  In compliance with Ind. Code 4-1-6, this agency is notifying you that you must provide the requested information, or your application will not be processed. You have the right to challenge, correct, or explain information maintained by this agency. The information you provide will become public record. Your examination scores and grade transcripts are confidential except in circumstances where their release is required by law, in which case you will be notified.

Mandatory Disclosure of U.S. Social Security Number:  Your social security number is being requested by this state agency in accordance with Ind. Code 4-1-8-1 and 25-1-5- 11(a). Disclosure is mandatory, and this record cannot be processed without it. Failure to disclose your U.S. social security number will result in the denial of your application. Application fees are not refundable.

Application Information

• IPLA Address/Phone Number/Web Site/Email/Fax Number

Indiana Professional Licensing Agency

ATTN: Respiratory Care Committee

402 West Washington Street, Room W072

Indianapolis, Indiana 46204

Staff Phone:  (317) 234-8800

FAX:     (317) 233-4236

Staff Email:   pla14@pla.in.gov

Website:       www.pla.in.gov

• Application: Part II Hospital or Facility of Employment And Part III. Respiratory School or Program Must Be Completed by Each Entity

• Part I. Applicant Infrmation: This sectin of the application shall be completed by the student applicant online or by paper application. Please make sure that all sections are completed and that you have answered all questions and signed the Affirmation.
• Part II. Hspital or Facility of Employment: This sectin of the application shall be completed by the licensed respiratory care practitioner designee at the hospital or facility where the student will be employed. Please make sure that the designee has completed all sections and read all information as to the supervisor’s responsibilities to the student permit holder. After the designee has completed the application and read all of the information, the designee must sign and date the Affirmation at the end of the form. Part II of the Application may be sent to the Committee directly from the Hospital or Facility of Employment.
• Part III. Respiratry School or Program: This sectin of the application shall be completed by the respiratory school or program to document which respiratory care procedures have been completed. Please have the Program Director and Director of Clinical Education complete this part of the application. The student will only be allowed to perform such procedures as checked-off on this form. The Program Director and Director of Clinical Education must sign and date the Affirmation at the end of the form. Part III of the Application may be sent to the Committee directly from the Respiratory School or Program.

Completed Part II and Part III of the applications may now be received from the student via upload or email.

• Issuance of Your Student Permit: Upon issuance of your student permit by the Committee, you will be sent an email notifying you that your permit has been issued. There will be instructions on how to purchase a blue license card to be mailed to you or how to download a free license card for immediate printing. You may log in to confirm issuance here.
  • Under a separate email, the student, hspital or facility and the school or program will receive a letter, which lists the procedures that the Committee has approved for the student to perform.

• Expiration of Your Student Permit: A student permit expires on the earliest of the following:

1. The date the permit holder is issued a license under this article.
2. The date the committee disapproves the permit holder’s application for a license under this article
3. The date the permit holder ceases to be a student in good standing in a respiratory care program approved by the committee. The graduation of a student permit holder from a respiratory care program approved by the committee does not cause the student permit to expire under this subdivision.
4. Sixty (60) days after the date that the permit holder graduates from a respiratory care program approved by the committee.
5. The date that the permit holder is notified that the permit holder has failed the licensure examination.
6. Two (2) years after the date of issuance.

• Upon Graduation from the Respiratory Care Program – Apply For Licensure: Your student permit will expire sixty (60) days after graduation from your respiratory care program. To obtain an application for respiratory care licensure, please go to the Committee’s website to download the application and instructions for licensure.
• May Only Perform Procedures That Have Been Successfully Completed:  An individual who holds a student permit may only perform respiratory care procedures that have been part of a course:

1. the individual has successfully completed in the respiratory care program designated; and
2. for which the successful completion has been documented and that is available upon request to the committee.

The procedures permitted may be performed only:

1. on adult patients who are not critical care patients; and
2. under the proximate supervision of a practitioner.

• Definition of Proximate Supervision: “Proximate supervision” means a situation in which an individual is:

1. responsible for directing the actions of another individual; and
2. in the facility and is physically close enough to be readily available if needed by the supervised individual.

• Supervision of a Student Permit Holder: A holder of a student permit shall meet in person at least one (1) time each working day with the permit holder’s supervising practitioner or a designated respiratory care practitioner to review the permit holder’s clinical activities. The supervising practitioner or a designated respiratory care practitioner shall review and countersign the entries that the permit holder makes in a patient’s medical record not more than seven (7) calendar days after the permit holder makes the entries.
• Number of Student Permit Holders Under Supervising Practitioner:  A supervising practitioner may not supervise at one (1) time more than three (3) holders of student permits issued under this section.

Respiratory Care Procedures and Adding Procedures After Issuance of The Student Permit:  The respiratory care procedures that are listed on page 5 of your application are the only procedures that have been approved by the Committee in which a student permit holder may perform. You may not modify the list.

If additional procedures have been completed after the issuance of your original student permit, please download the student permit application from our website and have the school or program complete Part III of the application. Also enclose a statement along with the student permit number that the following procedures are being added. This must come directly from the school or program and not the applicant.

Changing Supervisors or Locations:  If there is a change with a supervisor or location for the student permit, your place of employment must complete Part II of the application from our website and submit it to us with the student permit number for processing.

Additional Locations:  If a student intends to practice at multiple locations, each location will need to have a separate RCP student permit.  The student must complete the application process for each location.

Change of Address/Email:  If you have a change of address or email, please notify the Committee by calling (317) 234-8800 or by email at pla14@pla.in.gov or by fax at (317) 233-4236. You may also make your request in writing to:

Indiana Professional Licensing Agency

ATTN: Respiratory Care Committee

402 West Washington Street, Room W072

Indianapolis, Indiana 46204

Please be sure to include your student temporary permit number and/or your social security number with your request.

Statutes and Rules