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    Maryland Department of Health
    Board of Occupational Therapy Practice

    ​​​​​​​​​​​​​​​Downloaded Forms

     
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    Forms

    All documents may be submitted to the Board office via:

    1) Email:  mdotboard.user@maryland.gov    or

    2) Fax:  (410) 402-8561   or

    3) US Mail:  MD Board of Occupational Therapy, Spring Grove Hospital Center, 55 Wade Avenue, Tuerk Building, 2nd Floor, Baltimore, MD  21228.  

    Necessary Forms for an Initial License

    • Completed application​ and an application fee of $200.  Your payment must be mailed to the office; a scanned copy of your payment is not acceptable.

    • Completed State and FBI Criminal History Records Check (begin​ning February 1, 2018)   A copy of the Agency Privacy Requirements For Noncriminal Justice Applicants can be viewed here​ and here. ​ Please print out copies of both pages, sign them, and upload them with your documents.​ Fingerprint results are only valid for 30 days after being fingerprinted. Your application must be submitted within those 30 days.

    • Letters of verification from any state or country in which you've been licensed

    • Verification of initial certification or examination from NBCOT*

    • Continuing Competency Requirement Compliance Report Form (If you are currently NBCOT certified, the Continuing Competency Requirement is waived.  Continuing competency requirement documentation is required if your NBCOT certification is not current, you graduated more than one year ago, or if you have been out of practice for 3 or more years.)

    *For a temporary license, a confirmation of examination registration and eligibility to examine notice from NBCOT will be needed in lieu of NBCOT certification verification.

    ALL APPLICANTS SHOULD ALSO DOWNLOAD THE APPLICANT'S CHECKLIST AND BOARD SURVEY​​.​