Indiana
Telehealth Certification
Guide
Steps to Apply for Telehealth Certification - Out of State
STEP 1: Review the Application
Review the Online Application
Click Initial Application on the left-hand menu
Select Telehealth Certificate
Requirements that you need to submit with your application:
Indiana Professional License (Step 2)
Individual Certification (Step 3)
Employer’s or Contractor’s Certification (Step 4)
Application fee: $0.00
STEP 2: Submit Indiana Professional License
You must be licensed in the state of Indiana.
The Indiana Board will see that you have an active Indiana Professional License in your online account.
You do not need to submit a copy.
STEP 3: Submit Individual Certification
Please upload your Individual Certification to your online application.
You do not need your employer to sign the form. You are the only person who needs to sign the form.
To upload this document, please click on "Document Upload" in the menu section of your online account on the left hand side.
STEP 4: Submit Employer’s or Contractor’s Certification
Please upload your Employer's or Contractor’s Certification to your online application.
You do not need your employer to sign the form. You are the only person who needs to sign the form.
To upload this document, please click on "Document Upload" in the menu section of your online account on the left hand side.
Contact: Indiana Board Contact Information
Licensing Agency:
Indiana Professional Licensing Agency
Phone Number:
317-234-2067
Email Address:
pla4@pla.IN.gov
Mailing Address:
Indiana Professional Licensing Agency
Attn: SLPA Board
402 West Washington Street, Room W072
Indianapolis, IN 46204