NPTE APPEALS for candidates who have failed the exam at least 6 times: 11. Kallakuri, Deepthi - PT Exam - Education: Foreign (India) - Exam Attempts: 9

1. Kallakuri- Summary of exam takes (K 1) 2. NPTE Appeal Form - Kallakuri (K 2-5) 3. Application - Kallakuri (K 6-8)

ED's Recommendation: None

NPTE Appeal- Board Meeting - September 14, 2017

KALLAKURI: Dee~thi

Education: Foreign - (India)

Exam Attempts: (9)

Exam Dates State Score PT 05/25/2011 NC 532 PT 10/2612011 NC 559 PT 03/29/2012 NC 572 PT 07/31/2012 NC 552 PT 0112912014 NC 562 PT 10/29/2014 NC 571 PT 04/2912015 NC 542 PT 07/2212015 NC 579 PT 1012812015 NC 587

fsbpt

NPTE Appeal Form The only exception to the eligibility requirements will be at the explicit request of a state licensing authority. FSBPT will accept an appeal to the policy for ONE additional attempt from a state on behalf of a candidate who is seeking licensure in that state.

CANDIDATE SECTION (Candidate must complete and send to JURISDICTION) Candidate Name: .vEeP/HI k A i.c» J<:' o« , FSBPTID: 037-1 '1o~ Exam Level: I1r1>T o PTA Policy Being Appealed: &f"6-time lifetime limit - A candidate is ineligible to take the NPTE if the

candidate has made six or more prior attempts to pass that exam level. 02 very low scores - A candidate is ineligible to take the NPTE if the candidate has two scores at or below 400 on a given exam level.

State in which you are t..J 0 f<_. 'T H e.ARO L_i NA seeking licensure: Reason for appeal: PLEA 5& .s86- AlTA e..H6b C6-"16f<

EXAMINATION INFORMATION Exam Level (PT/PTA) Date State Score (If known)

Pl 10-- 23 - aots: IVC PT 01- 2.."2. - '2-015 fJc. P_1 Ott - 21 - 7-015 lle PT 10 -- '2-Q - 2-olf;- Ne- PT o I - '2-'7 .- 2-oit;-- NC- p, 07 - 31 ._ '2-0/2- NC- PT 03 - 2'1 - 2-l>/;'... AI(,_,

DISCIPLINE INFORMATION - Has any state or FSBPT taken a disciplinary action or issued you a sanction? Action Taken Date State Explanation tV/A

'r r c - 2-b -Z-l-'( /'J c: CY.4;"" L P I INF01iJ 'T as" _ 2.5- 2.-01 I ;Jt!... .'''' . Candidate Attestation:

The information I have provided above is accurate and I meet all the licensure requirements for the state in which I am seeking licensure.

Signature: __ ...;..k_:_'_· _'f)_~---,-+-- ~::..:'> _ Date:

CANDIDATES - CONTACT THE JURISDICTION IN WHICH YOU ARE SEEKING LICENSURE TO INQUIRE AS TO WHO THE CORRECT CONTACT IS TO PROCESS AN APPEAL ON YOUR BEHALF. ( http://www . fsb pt. org/F ree Resou rces/Licensi ngAuthoritiesContactl nfo rm atio n .aspx)

fsbpt

LICENSING AUTHORITY SECTION (To be completed by Administrator or Board Chair) Background information When did this candidate first seek licensure in your state? What evidence do you have that the candidate intends to practice in your state? Has the state imposed a remediation requirement for this candidate? At what point in the process was remediation required? Reason for Requesting Appeal

0 Candidate was attending PT/PTA school (receiving a second entry level degree) during the notification period (October 2014 - December 2015)

0 Candidate was not an active test taker after January 2011 (i.e., was not notified) 0 State law requires an additional attempt be granted

Citation: 0 Other

Rationale:

licensing Authority Attestation: I have reviewed the individual's prior examination history. S/he is eligible to sit for the exam and meets all licensure requirements and will be eligible for licensure in this jurisdiction if s/he passes the NPTE. I certify that I am authorized to present this request on behalf of the physical therapy licensing authority.

Name: _

Signature: _

Title: ------------------------------

Date: _

JURISDICTIONS - PLEASE EMAIL THIS FORM TO appeals@fsbpt.org

From:

Deepthi Kallakuri 51 Walnut Drive, Upper Saddle River, NJ 07458

To:

North Carolina Board of Physical Therapist Examiners

18 West Colony Place, Suite 140

Durham, NC 27705

Dated: 8th September 2017

Letter of Appeal, 6-time lifetime limit

Dear NC Board of PT Examiners,

I would like to first thank the board for accepting my application for PT, giving me opportunities to attempt NPTE and an avenue for pursing my passion of being a Physical Therapist in USA, through this appeal. My intense passion is driven by my previous experience as a practicing Physical Therapist in India - as Leonardo da Vinci once remarked 'For once you have tasted flight you will walk the earth with your eyes turned skywards, for there you have been and there you will long to return'. This truly sums up my drive to become a Physical Therapist in USA. Regrettably, I have not been able to achieve it thus far with a few factors influencing my path, in retrospect.

My path to fulfill my passion started with my application to the board. The board recommended additional courses to be considered eligible for taking the NPTE. After diligently finishing the recommendations, I was given my first opportunity to attempt the NPTE and attempted it in May of 2011. Regrettably, I did not get through. Though dejected, I found out that I was conceived with twins! Unfortunately, that was ephemeral, within a couple of months I went through a miscarriage. Crestfallen, I sought solace in pursing my passion. It is during these tough times that I attempted NPTE thrice more, albeit without success, as a way to get back at life for dealing such a blow. It only made matters worse.

My husband's job forced us to move out to New Jersey. Taking a cue that I needed to rejuvenate mentally, I took a step back from taking another attempt, driven by passion I enrolled into the IER Course and completed the course. Before I could apply for the exam, I found out that I was pregnant again forcing me shift my priorities as I did not want to go through the same experience again. We were blessed with a wonderful baby girl. Still driven to be a Physical Therapist, I was keeping myself abreast by studying through the formative years of my daughter - that was becoming increasingly difficult balancing preparation and being a first-time mother.

Being well prepared and geared up, I attempted NPTE in February of 2014 but failed. Taking time to analyze what might have caused the failure, I realized that my preparation and study plan were not

Letter of Appeal - Kallakuri

achieving it and sought help by enrolling into the third-party NPTE study program. Armed with new

found confidence and a revamped preparation, I attempted the exam again in November of 2014. The

failed result made me doubt myself, my abilities in all aspects of my life. Life threw another wrench with

an unplanned pregnancy. Trying to win over my daemons that were pulling me down, I was also feeling

the pressure to succeed. Immaturely thinking that having two young kids may spell an end to my

passion, I blindly set out to succeed in the exam. My second pregnancy added more complications in my

preparation. I was diagnosed with gestational diabetes, and mood swings - yet driven by fear and doubt,

I attempted the exam thrice in 2015 without any success. It was during the day of the last attempt that I found out that the rules were being changed and there was now a limit on the exam retakes.

After my failure of the last exam, I was completely devastated. The failure was uncharted waters for me

as I had never been in a situation where my experience and passion were overshadowed by only

failures. Counselling with my doctor and endocrinologist, I found out that the intense pressure added to the complications in my pregnancy had a hand in my failures. During my counselling sessions with them,

they urged me not to give up and try the exam once more. It is with their support and wishes that I have

gained good health, mental strength and rejuvenated will to purse my passion. I have attached a letter

from my endocrinologist indicating my state of health for your reference.

Reflecting upon myself and undergoing a true-to-self retrospective analysis, I realized that I was being too short-sighted, with undue aggressiveness and ill-prepared for the exams - a huge mistake. As the

19th century Danish philosopher, Soren Keirkegaard said, Life can only be understood backwards; but it must be lived forwards. It is with this understanding I stand before you with an earnest plea to grant me one last chance to attempt the NPTE exam. Retrospection over the last couple of years, I have realized

and taken steps to regain my health, both mentally and physically. I am also in the process of enrolling

into graduate-level exercise physiology courses to serve a refresher. I strongly believe that these courses

and additional preparation backed by a solid study plan will help me get through the NPTE Exam. I am

prepared to follow remedial actions set by the board and any other recommendations to help me

pursue my passion.

Thank you for your time.

Yours sincerely,

K·~ Deepthi Kallakuri

Letter of Appeal - Kallakuri 21Pilge

@ .. Bar,,!abas Health ._. Medical Group

UmtOO Mocilcal

612 RUTHERFORD AVE. LYNDHURST, NJ 07071 TEL (201 )460-0063 FAX (201 )460-1684

988 BROADWAY, SUITE 201 533 LEXINGTON AVE BAYONNE, NJ 07002 CLIFTON, NJ 07011 TEL (201 )339-6111 FAX (201 )339-6333 TEL (973)546-6844 FAX (973)546 7701

---

June 1, 2017

To whom it may concern:

I am Dr Marina Strizhevksy, Endocrinologist, for Mrs Deepthi Kallakuri, who is under my care for thyroid disorder. During her prior 2 pregnancies in 2012 and 2015 she had been diagnosed and treated for Gestational Diabetes Mellitus for which she required insulin treatment and frequent visits to the doctor for monitoring and treatment adjustment which took up most of her time. Currently Mrs Kallakuri if free of diabetes and only requires thyroid hormone treatment. If you have any additional questions, please do no hesitate to contact me at my office at 201-460-0063.

sinjJJk Marina Strizhevk~

Marina Strizhevsky, D.O. BHMG-United Medical 531 Lexington Ave Clifton, NJ 07011 (973) 546-6844

~. FOR OFFICIAL USE ONLY PTEXamA~~~~~ted I \IY .. __ ~~~~_~~_ii. ••• P,T , Examination Date: ' Date Received: .:t_/ga_/~ , ',-;r;_ Fee:DCl4=F Oep#: Oa"t E 10 Number:

---~ License No: --------1 , o End: ;:.;- 1iZl Ex: tiC - 'P-U'Ji.J~ J~ tfRev by End: __ -­ o Exost: __ --- SCORES:

Scaled: __ '---:-++r::""""',£--' _ Raw: __ '___:~+- _

Issued Date: -------t

.!ame:

NC Passing: Scaled: __ , ~ _ Raw: ,

Granted By: o End: _ o Ex: -:--=---:,-- _ o Rev by End: _ o Exost: _

North Carolina Board of Physical Therapy Examiners Application for Physical Therapist Licensure

Zip code: 01-Y 5~

Name: Mr. Ms. Mrs. Dr. / First Name: :DEf: ?1 \\1 Middle Name: Last Name: f).AlL8 foRI Maiden Name: f\tAL~

PRINT your name exactly as you want it to appear on your certificate of licensure. DEePI\{[ K~LL-AKtJ'~r:

Entry Level Physical Therapy Education II. List physical therapist program conferring degree or certificate.

SCHOOL AND LOCATION DATES ATTENDED DEGREE OR CERTIFICATE DDH..o BL) \l1D"It\f'J f\CM\Rp \t"j OERII\ B~j). t<j9Q-oo w ef(· o::p.coS . BPlc..tl<ClJ>g_ of' Pl:\tS[O~MffiY·

Professional Licensure III. List ALL states in which you have ever been licensed regardless of status of license at this time.

STATE License # DATE OF METHOD OF LICENSE IS LICENSE CURRENT ORIGINAL LICENSE (EXAM, ENDORSEMENT, etc.)

1.

2.

3. (list additional licenses on a separate sheet and attach)

Professional Employment IV. When and where do you anticipate employment in North Carolina? Please enter "NONE" if

unknown. a. DATE PLACE SUPERVISOR

~ b. If employed as a contract therapist, list name and address of employer.

c. Starting with PRESENT position list your professional employment. DATES NAME AND ADDRESS OF INSTITUTION SUPERVISOR

1. Have you ever used a name other than the one on the front of the form? If yes, give name(s) _

2. Have you ever taken the physical therapist licensing examination?

3. Have you ever been denied the privilege of taking a physical therapist licensing examination?

If yes, give state(s): _

7~6-#3~ (R-Y

YES NO

\/

IF YOU ANSWER YES TO ANY OF THE FOLLOWING QUESTIONS, GIVE DETAILS ON A SEPARATE SHEET AND ATTACH.

4. Has disciplinary action ever been taken or is pending against you by a PT Licensing board?

Have you ever used drugs or alcohol to the extent it adversely affects professional competence? Have you ever been convicted for violating any narcotic or controlled substance law? (Do not include convictions that have been expunged.) Have you ever been convicted of a felony or other public offence involving moral turpitude? (Do not include convictions that have been expunged.) Have you ever been found to have committed an act or acts of malpractice, gross negligence or incompetence in the practice of physical therapy? Have you ever had an adjudication of insanity or incompetence?

5.

6.

7.

8.

9. v'

VI. FEES: Certified check or money order payable to: NC Board of Physical Therapy Examiners must accompany application. Personal or business checks will be returned.

Application fee is NOT refundable

Check One: o Applying for licensure by endorsement o Applying for licensure by examination in another state Il2'f Applying for licensure by examination in North Carolina: (examination cost $400.00 to be paid directly to FSBPn

$150.00 $150.00 $150.00

Exam Candidates: List preferred examination date: __ ..:..O::....g-ljr-- __ o<'~%'..!oL._-___..!,\S::::· :...._ _

If you have a disability and need an accommodation at the exam, check here You will receive a Request f~r_ ~,:,:'!'!'_"!'!c!"!tj'!'! !_orl_!1 ~!'!c_'!. !!!_u_s_t_ b_e_ ~,!,!I_!1!t.!f!lj _a_t !f!.'!.s_t_ ~~ lj,!~~ p~!,!r_e_ ~h_e_ ~J!.a_"!~n_a_t~":..n.: _ VII. AFFIDAVIT ~, ..-

By signing the application I, Det:-P1}\L l\& LLf\ KlJ RI· , do hereby state that I am the person referred to in this application for a license to practice as a physical therapist in North Carolina and to the best of my knowledge and belief the statements in my application are true in every respect. The attached photograph is a true likeness of me. I authorize former employers, schools, references, testing services and other licensing boards to give any job related, personal or licensing information they may have

-- ------ - - regarding me. I hereby release them from all liability for issuing such information.

I

I :""ign in the presence of a Notary Public

ltr Sworn to me before this _-:l/I-'~ "" _

N,C. Board of Physical Therapy Examiners 18 West Colony Place, Suite 140

Durham, NC 27705

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