ARTP PQ Extension Request Form

This form is to be completed only by those undertaking a ARTP Practitioner, Associate or Clinical Professional Qualification.

You must not complete this form if you are undertaking a Sleep Certificate, CPET Certificate or Spirometry Certificate

Application for Professional Qualification Extension

Please note - 6 month deferral extensions are granted only under exceptional circumstances, such as long-term illness, transfer of hospital, family bereavement. Supporting evidence, such as a sick note or a letter/email from a senior staff member, must be submitted with the application for a 6 month extension.

*Candidate Name

*Candidate Email

*What ARTP qualification are you undertaking?PractitionerAssociateClinical Top Up

*Please select which extension you are applying for2 month extension6 month extension

*For those applying for a 6 month extension, please provide evidence from a manager to support your application

*Reason for extension