State of Wisconsin Department of Regulation & Licensing
Ensuring the availability of safe and competent professional services 		Secretary Celia Jackson
 Secretary Jackson
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Occupational Therapist - Forms

You will need to choose one of the application packet(s) listed below. Every form in the packet that you choose must be submitted if it applies to your situation.

Petitions for refunds must be in writing and may be granted only if the criteria set forth in Wis. Admin. Code s. RL 4.06 are met.

Occupational Therapist Application Packet

Form #
Title
Occupational Therapy Licensure Information
Application for a License to Practice Occupational Therapy
Addendum to Application (SS# -required)
Occupational Therapy Certificate of Professional Education (This form must come directly from your school)
Request for Temporary License for Occupational Therapy
Wisconsin Statues and Rules Examination (Required online exam )
NBCOT Verification of Certification Request Form
Convictions and Pending Charges
Bibliography for Oral Exams
Notice (department information)

Other Information / Forms

Title
Disability Modification Request Form for Examinations
Professional Verification of Request For Modification

 

Last updated: Thursday, July 16, 2009