License Application Forms: Occupational Therapist &
Occupational Therapy Assistant
Instructions for completing and submitting the forms required for
licensure appear below. You may also need to submit additional
information (for example, examination scores). Please refer to
the license requirements link on the left for
complete information regarding all
requirements you must meet.
Note: All forms are in Adobe
Portable Document Format (PDF). To view or print these documents,
you will need to have the free Adobe Reader installed on your
computer. Download times and print quality will depend on your
connection speed and printer.
Form 1 - Application for Licensure & First
Registration (ot1.pdf; 41K; 4 pages)
All applicants for licensure and certification must complete and
submit this form with the licensure and registration fee directly to
the Office of the Professions at the mailing address at the end of
Form 1. Make checks payable to the New York State Education
Department. Your cancelled check is your receipt. You must answer all
questions and provide all information requested unless otherwise
indicated. Failure to complete all required parts of the application
will delay its review. Your signature on Form 1 must be notarized by
a notary public.
Please Note: Occupational Therapy
Assistant applicants are not required to complete questions 9-13 on
this form.
Address/Name Change Form - Optional
(anchange.pdf; 16K; 2 pages)
Use this form if you have had a legal name change or to update
your address information in our records.
Please note: Change of address
notifications may be e-mailed, faxed or mailed to the Office of the Professions at the
address on the form. Change of name notifications must be notarized
and cannot be faxed or e-mailed.
Form 2 - Certification of Professional
Education - (ot2.pdf; 22K; 2 pages)
This form must be submitted directly from the professional
school.
Occupational Therapist:
For approved New York State Registered or AOTA Accredited
Programs: Complete Section I. Be sure to sign and date item 8 and
forward the form to your school. Your school must complete Section II
and send the form directly to the Office of the Professions at the
address at the end of the form.
Non-AOTA Accredited Programs Outside The U.S.: If your education
was obtained in another country, do not use Form 2.
You must have your educational credentials verified by an independent
credentials verification organization before the New York State
Education Department can determine if they meet New York State's
requirements for licensure. Refer to the "Education Requirements" section.
Contact CGFNS for the form and procedures for the independent
verification of your educational credentials.
Non-AOTA Accredited Programs In The U.S.: Contact the Bureau of
Comparative Education at: comped@mail.nysed.gov or (518)
474-3817 ext. 300.
Occupational Therapy Assistant:
For approved New York State Registered or AOTA-Accredited
Programs: Complete Section I. Be sure to sign and date item 8 and
forward the form to your school to complete Section II.
Form 5 - Application for Limited Permit -
(ot5.pdf; 25K; 2 pages)
If you are applying for a limited permit to practice occupational
therapy, complete Section I of Form 5, have your employer and
supervisor complete Section II and submit it with the $70 fee to the
address indicated. Application for licensure, including the licensure
fee of $294, and verification of education must be received prior to,
or along with, the application for a limited permit.
Individuals applying for a limited permit who have completed all
degree requirements but have not received their degree from a New
York State registered/licensure-qualifying or AOTA-accredited
program, may request their school to complete a Certification of
Professional Education (Form 2) with the "met all
requirements" date filled in. If this process is followed, you
must re-submit another Certification of Professional Education (Form
2) to the school after the degree has been awarded for verification
of receipt of the degree, which is required for licensure.
If you change employment or supervisor after a permit is issued,
you must obtain a new permit and, with each prospective
employer/supervisor, complete a new Form 5 and return it to the
Office of the Professions. A new fee is not required for a permit
issued as a result of a change in employment.
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