Your Physiotherapist Accountabilities

Here are a list of requirements to maintain your PT licence. As a registered physiotherapist you need to do the following. Click on each icon below for more information and links.

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The MUSTs for Physiotherapists


What: Complete PISA Annually 

PISA or the Professional Issues Self Assessment is a short, multiple choice, online exercise that must be completed annually by all registered physiotherapists (both Independent Practice Certificate and Provisional Practice Certificate holders). 

PISA is an opportunity for you to assess your awareness of practice issues, reflect on practice-related questions and have a look at resources and Standards on the College’s website.

It is short (9 questions) and is not scored (that’s right, there is no pass or fail—you just need to complete it).

View More Information about PISA


What: Carry Adequate Liability Insurance

When: From Day One

Insurance protects patients and physiotherapists in the event something goes wrong. You are required to carry a liability limit of at least $5 million dollars per incident, and a minimum coverage of $5 million for your annual policy period.

If your employer doesn’t insure you, insure yourself (and remember, insurance from one employer does not cover you for others).

It is crucial to carry ‘tail insurance’ of at least 10 years, in case a patient initiates legal action against you when you’ve taken a hiatus from, or cease, practicing. They’re able to do so up to 10 years after.

Learn More about Liability Insurance


What: Be Professional

When: Every Day

So you know the Standards, the rules and regulations. You’ve done your PISA, your portfolio’s up to date, you keep your registration current. What about the day to day?

This is common sense, but just in case: remember you’re representing. The physiotherapy profession as a whole needs you to dress appropriately, carry yourself with respectful authority, and communicate well with the people you serve.

It’s about more than just dotting the i's in clinical (work). Patients expect and deserve an excellent experience, moment by moment. So please, do us right. Be sensitive to cultural differences. Be polite. Get consent. Don’t cross boundaries.


What: Read College Communications

When: We Send Them

Please open and read all College communications. Please check you’ve provided us a working email address, so you receive what we send. If you haven’t recently heard from us (we send out 1 email/month, called Perspectives), get in touch and tell us:

Read Archived Issues of Perspectives


What: Complete Jurisprudence

When: Every 5 Years

Every registered physiotherapist must complete and submit a Jurisprudence Module, which demonstrates their knowledge of, and ability to, apply College Standards. You complete the online, multiple-choice module during your first year of registration with the College, and then as part of a five-year cycle afterward.

Read More about Jurisprudence


What: Audit Your Billing

When: Regularly

Whenever you start a new role, make sure you understand the billing processes your employer uses. Read the Fees and Billing Standards (every one). You’ll know what you need to do and what you’re accountable for (e.g. periodic audits of invoices using your name and registration number, ensuring fees charged are not excessive, confirming a documented fee schedule exists for each funding program).

Remember your name and registration number can only be used for physiotherapy you delivered (or assigned to a physiotherapist assistant or student you were supervising).

If you leave an employer, they cannot continue using your name and registration number for any billing. Remind them of this, if and when you go.

Read the Fees, Billing and Accounts Standard


What: Be Accountable

When: As a Matter of Course

Being a self-regulated health professional means you’re accountable for your actions. You can call upon supporters such as your peers, the College’s Practice Advisor at or the Ontario Physiotherapy Association, but you will be held responsible for any violations of laws that govern your profession.

This applies to actions carried out by another on your behalf (e.g., a receptionist who does your billing, a physiotherapist assistant you’re supervising), and to actions suggested by another (a mentor, supervisor, doctor, employer). It’s you who makes the final decision.  

Watch Our Video: Self-Regulation


What: Physiotherapists must maintain confidentiality of patient information. But if someone’s in danger, duty to warn supersedes your duty to maintain confidentiality.

When: Always

What’s duty to warn?

It’s a legal term, a provision in the law allowing you to break confidentiality when, using your best judgment, you decide it’s of the utmost importance to keep people safe.

As you know, privacy laws dictate physiotherapists must maintain confidentiality of patient information. Normally, you can’t release anything without patient consent.

But this is different.

If someone’s in danger, duty to warn supersedes your duty to maintain confidentiality. You must act if your patient (or others) may come to harm.

How Do I Act?

It depends what constitutes the potential harm. The following are three examples:

  • A patient who is talking about killing themselves.
  • A teenage patient with cuts on their forearms.
  • A patient who is obviously under the influence of drugs or alcohol.

What should I do?

If you believe there is an immediate risk of harm, for example:

  • The patient’s suicidal ideation is at a critical point—call a family member.
  • The teenager’s cuts are fresh—contact a parent.
  • The drunk or high patient is about to drive away—call the police.

If danger isn’t imminent, and you needn’t immediately act, you must obtain patient consent to proceed. If the patient is considering but not yet attempting suicide, you might call their family doctor or a counselor. Ask the teen if they’ve told anyone about their cutting behavior. See if the alcoholic or addict has any kind of support in place. If not, can you call someone for your patient? How can you best assist them?

Unfortunately, if the patient doesn’t want you to do anything, your hands are tied. But you should continue to monitor the situation, and if it worsens, consider acting.


What: Talk to the Practice Advisor and Your Peers

When: You Need to

Being a physiotherapist is not always easy. We encourage everyone to ask lots of questions and talk through challenging situations with a trusted peer or the College Practice Advisor. Practice advice is free, and it can be anonymous. Always reach out.



What: Make Mandatory Reports

When: It’s Required

If they become aware of them, registered health care professionals are required to report serious issues that could harm patients, the practice and their peers. It’s law.

You must report anyone who is not a registered physiotherapist but is pretending to be one by calling themselves a physiotherapist, or by misleading patients into thinking their care is being provided by a PT. This deception is called ‘holding out’.

You must warn authorities when someone is in serious danger (‘Duty to Warn’).

You must report if you know a patient is being sexually abused by any regulated health care professional (this includes inappropriate touching, behaviour and/or remarks). You also have an obligation to report suspected child and elder abuse or neglect. Where a health care professional has reasonable grounds to suspect a child is, or may be, in need of protection, it is their legal duty to report it to the Children’s Aid Society. Any professional who fails to report a suspicion of child abuse or neglect, if convicted, is liable for a fine of up to $1,000. For contact details and other information covering all Ontario’s Children’s Aid Societies, visit

If you end a partnership, health professional corporation or association due to misconduct, incompetence or incapacity of yourself or a peer (e.g., you or your peer is experiencing addiction issues, mental health issues, or is putting patients at risk due to a lack of clinical skills), you are obligated to report as much to the College.

Employers (PT or non-PT) must report if they terminate an employee or dissolve a partnership, health profession corporation or association with a physiotherapist, for reasons of professional misconduct, sexual abuse, incompetence or incapacity. This is required even if the person in question resigned before they could be reported.

Not sure if you need to report something? Contact the College’s Practice Advisor:


Make a Mandatory Report


What: Self-Report

When: It’s Required

Mandatory reporting is an important component of regulating physiotherapists in Ontario. Reports alert the College to situations where a person may not be practicing safely, and allow us to take appropriate and necessary steps to protect the public. Any physiotherapist must self-report to the College if she or he:

  • has been found guilty of an offence in any jurisdiction

  • has been charged with an offence in any jurisdiction

  • has a finding of professional negligence and/or malpractice

  • has a finding of professional misconduct, incompetence, incapacity or any similar finding, in relation to the practice of nursing or any other profession in any jurisdiction; and/or

  • is the subject of a current investigation, inquiry or proceeding for professional misconduct, incompetence, incapacity or any similar investigation or proceeding in relation to the practice of nursing or any other profession in any jurisdiction

Failing to self-report is a serious matter and can result in a referral to discipline.

File a Self Report


What: Update Your Contact Information—Let Us Know

When: You Make a Change

It’s mandatory to inform the College about changes to your name, employment information or contact details (previously provided information to the College) in writing, within 30 days of the change.
Your information appears on the Public Register so patients can find you, insurers can confirm your employment, and we can reach you. Use the online member portal to update your details. If you have questions, email

Visit the Public Register

Update Your Information


Practice Scenario

Refresh Yourself

Jeff had been working in the ICU for the last several years. Initially the intensity and urgency of this practice setting was what attracted him. But of late he’d started to feel burnt out. Wonky hours and the rush of seeing so many critical patients (with so little time) had lost their lustre. He missed the one-on-one of the clinic setting, where he’d had room to build ongoing relationships with his patients, and see the difference he could make with repeated exposure to his ‘regulars’ as they improved.

The College relied on Jeff to be responsible about any changes in his physiotherapy practice, from setting through skillset. His area of focus had been narrowed over these recent years to the kinds of treatments he could effectively provide in the ICU. He had to admit he’d probably be rusty when it came to what he’d be doing back at a clinic. And things might’ve changed a lot while he was away. To ensure competence—his ability to provide safe care for future patients—he knew he’d have to brush up.

Turning to a colleague who’d never left the clinic setting, Jeff asked to shadow her and see what he’d been missing. With her supervision and feedback, he tried some trial runs, consulting with other clinic physiotherapists to determine the learning gap he’d need to fill. He hadn’t forgotten much, but treatment modalities had certainly diversified with new technologies. And most important for Jeff was re-familiarizing himself with the physical skills he’d need on a daily basis. Once they felt like second-nature to him again, he knew he was ready to make the switch.

All he had left to do was to inform the College about his change in practice.


What: Roster for Controlled Acts

When: You Fit the Below Criteria

You must roster with the College if you work with a physiotherapist assistant or perform any of the following procedures:

  • tracheal suctioning

  • spinal manipulation

  • acupuncture (including dry needling)

  • treating a wound below the dermis

  • assessing or rehabilitating pelvic musculature

  • administering a substance by inhalation

Learn More about Rostering


What: Renew Your Registration

When: February 1 to March 31

Please keep your information current and accurate.

  • Do you work with physiotherapist assistants?

  • Have you completed PISA?

  • Who is your liability insurance provider?

  • What’s your policy number?

  • What have you rostered for?

  • What do you want to be rostered for?

Learn More about Registration Renewal


What: Continuing Professional Development


As professionals, you have an obligation to keep your knowledge and skills up to date. PTs are required to:

  • Participate in continuing education and professional development each year, to the extent needed to maintain the knowledge, skills and judgment you need to practice

  • Keep a record of your continuing education and professional development activities for at least five years

  • Provide the record of your continuing education and professional development activities to the College upon request

The College does not have specific requirements for the amount and type of continuing education and professional development activities you do. It is up to you to identify your own learning needs. Contact the Quality Assurance team with questions.