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    NBCOTCertifcationograms are accredited by:

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    NBCOT does not discriminate against any individual because of race, ethnicity, gender, age, creed, disability,

    religion, marital status, sexual orientation, or national origin. NBCOT reserves the right to amend the

    procedures outlined in this handbook. For the most up-to-date information concerning the certification

    examinations, please visit www.nbcot.org, e-mail: [email protected], call 301-990-7979 or fax: 301-869-8492.

    This publication is intended solely for the use of internationally-educated candidates applying to take the

    NBCOT Certification Examination in 2013.

    AOTCB/NBCOT 2013 Examinations ID 34 rev120612

    All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in

    any form or by any means (electronic, mechanical, photocopying, recording, or otherwise) without prior written

    permission of the copyright owners.

    2013 National Board for Certification in Occupational Therapy, Inc.

    NBCOT is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.

    OTR is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.

    COTA is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.

    All marks are registered in the United States of America.

    National Board for Certification in Occupational Therapy, Inc.

    12 South Summit Avenue, Suite 100

    Gaithersburg, MD 20877

    http://www.nbcot.org

    Printed in the United States of America.

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    Introduction

    About NBCOT

    ........................................................................................................................ 2About This Handbook ............................................................................................................. 2

    Purpose of the Examinations ................................................................................................ 2

    Examination Development .................................................................................................... 2

    Examination Administration .................................................................................................. 3

    Certication Eligibility Requirements

    Certification Eligibility Requirements .................................................................................... 3

    Eligibility Appeal Process ....................................................................................................... 3

    NBCOT Candidate/Certificant Code of Conduct .................................................................. 4

    Application Process

    Submitting the Application .................................................................................................... 6

    Online Application for First Time Exam Candidates ........................................................ 6

    Hardcopy Application for First Time Exam Candidates ................................................... 7

    Character Questions .............................................................................................................. 7

    Reporting Services ................................................................................................................. 8

    Conrmation of Exam Registration/Eligibility of Exam Notice........................................ 8Ofcial Score Transfer ....................................................................................................... 8

    Fees ......................................................................................................................................... 9

    Special Testing Accommodations ......................................................................................... 9

    Taking the Spanish OTR Certification Examination ............................................................ 9

    Approved Applications

    Authorization to Test (ATT) Letter ........................................................................................ 10

    Checking Exam Application Status ..................................................................................... 10

    Scheduling the Certification Examination .......................................................................... 11Biometric Candidate Notice During Scheduling/Registration ........................................... 11

    Name and/or Address Changes ..........................................................................................12

    Application Withdrawal and Refund For Personal and/or Medical Emergencies ............ 13

    Cancellation, Rescheduling, Late Arrival or No Show for Scheduled Examination .......... 13

    NBCOT Exam Products and Service Refund Policy ............................................................ 14

    Preparing for the Exam

    Examination ..........................................................................................................................15

    Multiple Choice Items ..................................................................................................... 16

    Simulation Test Items ..................................................................................................... 16

    Study Tools............................................................................................................................ 17

    Exam Day: Questions & Answers ...........................................................................................18

    After The Exam: Questions & Answers.................................................................................. 21

    Retaking the Exam.................................................................................................................23

    NBCOT Certication Renewal: Keep Your Credential Active! .............................................24

    Summary of Exam Candidate Requests................................................................................25

    Appendix ...................................................................................................................................26

    TABLE OF CONTENTS

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    About NBCOT

    The National Board for Certification in Occupational Therapy, Inc. (NBCOT) is the national certification body for

    occupational therapy professionals in the United States.

    The mission of NBCOT is to serve the public interest by advancing client care and professional practice through

    evidence-based certification standards and the validation of knowledge essential for effective practice in

    occupational therapy. NBCOTs vision is certified occupational therapy professionals providing effective evidence-

    based services across all areas of practice worldwide.

    Currently, 50 states, Guam, Puerto Rico and the District

    of Columbia require NBCOT initial certification for

    occupational therapy state regulation, (e.g., licensing).

    NBCOT certification programs have received and

    maintained accreditation by the American National

    Standards Institute (ANSI) and the National Commission

    for Certifying Agencies (NCCA). NBCOT is a proud member

    of the Institute for Credentialing Excellence (ICE).

    About This Handbook

    This handbook has been developed to provide

    internationally educated exam candidates with the

    information to complete and successfully submit a

    certification examination application. NBCOT recognizes

    the responsibility exam candidates take when completingtheir exam application. Our aim is to provide a smooth and

    positive application experience.

    Purpose o the Examinations

    The primary purpose of the NBCOT certification examinations is to protect the public interest by certifying only those

    candidates who have the necessary knowledge of occupational therapy to practice. The OCCUPATIONAL THERAPIST

    REGISTERED OTR examinations are constructed to measure entry-level competence of candidates who have met

    eligibility requirements for OTR certification.

    Examination Development

    The OTR examinations are constructed based on the results of practice analysis studies. The studies identify the

    domains, tasks, knowledge and skills required for occupational therapy practice relative to the OTR credential. The

    ultimate goal of a practice analysis study is to ensure that there is a representative linkage of examination content to

    practice. The periodic performance of practice analysis studies assists NBCOT with evaluating the validity of the test

    specifications that guide content distribution of the credentialing examinations.

    Visit www.nbcot.org for a listof Frequently Asked Questions

    regarding the certificationexamination

    and application.

    Questions can be directed [email protected], or by phone

    (301) 990-7979.

    INTrOduCTION

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    Examination Administration

    The NBCOT certification examinations are administered at Prometric Test Centers (PTCs) worldwide. Prometric

    delivers and administers more than 10 million tests a year on behalf of approximately 400 clients in the academic,

    financial, government, healthcare, professional, corporate and information technology markets. It delivers test

    flexibly via the Web or by utilizing a robust network of more than 10,000 test centers in more than 160 countries.

    For more information, please visit www.prometric.com.

    Visit NBCOT on Facebook www.facebook.com/NBCOTCertification

    Visit NBCOT on Twitter www.twitter.com/NBCOT

    Visit NBCOT on LinkedIn www.linkedin.com/groups?gid1140837

    Certifcation Eligibility Requirements Graduating with an accredited/approved entry-level occupational therapy degree

    - Masters degree in occupational therapy OTR exam

    Completing all eldwork requirements Agreeing to abide by the NBCOT Code of Conduct Attaining a passing score on the NBCOT OTR certication examination

    Eligibility Appeal Process

    If a candidate is determined to be ineligible to take the certification examination, the candidate has the rightto appeal that decision in writing to the NBCOT Board of Directors. Within 21 days of receipt of the ineligibility

    notification, the candidate may submit a letter of appeal. The letter MUST outline the grounds for the appeal,

    including reasons why the application should be recognized and accepted by NBCOT. All letters should be sent via

    traceable mail (i.e., certified, UPS, Federal Express) to:

    NBCOT, Inc.

    Attn: President and Chief Executive Officer

    12 S. Summit Avenue, Suite 100

    Gaithersburg, MD 20877

    CErTIFICATION ELIgIBILITy rEquIrEmENTS

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    NBCOT Caniate/Cetificant Coe of Conct

    Preamble

    The National Board for Certification in Occupational Therapy, Inc. (NBCOT, formerly known as

    AOTCB) is a professional organization that supports and promotes occupational therapy practitioner

    certification. This Candidate/Certificant Code of Conduct enables NBCOT to define and clarify the

    professional responsibilities for present and future NBCOT certificants, i.e., OCCUPATIONAL THERAPIST

    REGISTERED OTR (OTR) henceforth OTR, and CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA

    (COTA) henceforth COTA.

    It is vital that NBCOT certificants conduct their work in an appropriate and professional manner to earn

    and maintain the confidence and respect of recipients of occupational therapy, colleagues, employers,

    students, and the public.

    As certified professionals in the field of occupational therapy, NBCOT certificants will at all times act

    with integrity and adhere to high standards for personal and professional conduct, accept responsibilityfor their actions, both personally and professionally, continually seek to enhance their professional

    capabilities, practice with fairness and honesty, abide by all federal, state, and local laws and

    regulations, and encourage others to act in a professional manner consistent with the certification

    standards and responsibilities set forth below.

    Where the term certificant is used, the term applicant or candidate is included in its scope.

    Principle 1

    Certificants shall provide accurate and truthful representations to NBCOT concerning all information

    related to aspects of the Certification Program, including, but not limited to, the submission of

    information: On the examination and certication renewal applications, and renewal audit form Requested by NBCOT for a disciplinary action situation Requested by NBCOT concerning allegations related to:

    test security violations and/or disclosure of condential examination material content tounauthorized parties;

    misrepresentations by a certicant regarding his/her credential(s) and/or education; the unauthorized use of NBCOTs intellectual property, certication marks, and other

    copyrighted materials.

    Principle 2

    Certificants who are the subject of a complaint shall cooperate with NBCOT concerning investigations of

    violations of the Candidate/Certificant Code of Conduct, including the collection of relevant information.

    (continued)

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    Approved June 2002 copyright 2011, NBCOT, Inc.

    Revised February 2003

    Revised June 2006

    Revised October 2008

    Revised January 2010Revised November 2011

    Principle 3

    Certificants shall be accurate, truthful, and complete in any and all communications, direct or indirect,

    with any client, employer, regulatory agency, or other parties as relates to their professional work,

    education, professional credentials, research and contributions to the field of O.T.

    Principle 4Certificants shall comply with laws, regulations, and statutes governing the practice of occupational

    therapy.

    Principle 5

    Certificants shall not have been convicted of a crime, the circumstances of which substantially relate

    to the practice of occupational therapy or indicate an inability to engage in the practice of occupational

    therapy safely, and/or competently.

    Principle 6

    Certificants shall not engage in behavior or conduct, unlawful or otherwise, that cause(s) them to be, or

    reasonably perceived to be, a threat or potential threat to the health, well-being, or safety of recipients

    or potential recipients of occupational therapy services, students or colleagues.

    Principle 7

    Certificants shall not engage in the practice of occupational therapy while ones ability to practice is

    impaired due to chemical (i.e., legal and/or illegal) drug or alcohol abuse.

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    Hardcopy Application for first-time exam candidates

    A hard copy exam application can be downloaded from the NBCOT website, and is also located in appendix B

    of this handbook.

    Step 1: Read the instructions outlined in this handbook

    Step 2: Complete all applicable sections of the application.

    Under the exam application Section 3: Exam Eligibility Pathwayselect the checkbox for OTED A signature is required on the Attestation Statement. Make a photocopy of the completed application for your records.

    Step 3: Mail the application, along with payment to: NBCOT, Inc. P.O. Box 64971 Baltimore, MD 21264.

    NBCOT recommends that the application be sent via traceable mail (e.g. certied). If a working e-mail address (username) and password were provided in the application, the candidate

    can use them to check the status of the application online at www.nbcot.org.

    Character Questions

    This section MUST be completed by all candidates.

    If a candidate answers yes to any of the character questions on the application, the following information MUST

    also be submitted:

    1. A written explanation of the events regarding the incident or question to which yes was answered.

    2. Copies of any official documentation related to the incident, including police reports showing the initial

    charge(s), court documents showing sentencing requirements or documents showing how the case was

    resolved, e.g., dismissed, pre-trial program.

    3. Any additional information or documentation, such as remedial measures taken since the incident including

    letters from parole or probation officers confirming successful completion of probation, or a letter confirming

    successful completion of chemical dependency treatment.

    For initial felony charges or felony convictions, candidates MUST answer affirmatively and submit supporting

    documentation, even if records, charges, or convictions have been pardoned, expunged, pled down, released, or

    sealed. All information MUST be submitted to and reviewed by NBCOT before the examination application will be

    approved.

    If an exam candidate has been charged with and/or convicted of a felony at any time before or after issuance of

    an Authorization To Test (ATT) letter, the candidate MUST notify NBCOT immediately. If the candidate fails to inform

    NBCOT, disciplinary action may result. Notifications should be sent to:

    NBCOT, Inc.

    Attn: Qualifications and Compliance Review

    12 S. Summit Avenue, Suite 100

    Gaithersburg, MD 20877

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    Reporting Services

    NBCOT offers the following reporting services:

    Conrmation of Examination Registration and Eligibility to Examine Notice Ofcial Score Transfer

    The candidate is responsible for contacting the occupational therapy state regulatory board to determine which

    service(s) is required.

    Confrmation o Examination Registration and Eligibility to Examine Notice

    This service confirms that a candidate has, in fact, applied for and been deemed eligible to take the national

    certification examination. This service requests NBCOT to send a confirmation notice to any third party (a U.S. state

    regulatory board if seeking a temporary/limited permit, employer, etc.) or to a candidate who wishes to have a notice

    for their personal records. There is a fee per notice.

    The notice contains the following confirmations:

    1. Examination application and fees have been processed

    2. Official final transcript has been received & accepted

    3. Candidate has been approved to schedule a test date with Prometric

    4. Candidates examination history: a listing of the dates of examinations, 1997 - present

    Ofcial Score Transer

    This service requests NBCOT to send an Official Score Transfer(also known as the Score Report) to a U.S. state

    regulatory board. A state regulatory board will NOT automatically receive a score report unless an official score

    transfer service has been ordered. There is a fee for each score report sent.

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    Ordering reporting services at time of application:

    Select the service on the application. Candidates may log onto their online exam application to add services

    while the application is in New status but cannot remove or substitute services. For example, a score report

    request to a state may not be removed or substituted for a score report to another state.

    Ordering reporting services after the exam application has been submitted:

    Candidates should contact NBCOT to order additional reporting services.

    Ordering reporting services after exam has been taken:

    If an applicant orders a reporting service after the exam has been taken, the candidate MUST submit

    the appropriate request form with payment to NBCOT. Forms for reporting services can be found at:

    www.nbcot.org > Forms > NBCOT Certification Examination Forms > North America.

    Ordered items cannot be cancelled or refunded.

    Fees

    Payment for examination applications and related services such as score transfer, confirmation of exam registration,

    and eligibility to examine notices must be made by credit card (MasterCard or Visa). Candidates applying for the

    OTR examination MUST pay the fee at the time the application is submitted. No off-line payments will be accepted.

    An application cannot be processed until all fees are paid in full.

    For a detailed fee schedule, see the payment section of the application in Appendix B of this handbook. Questions

    can be directed to NBCOT via e-mail at [email protected] by phone at 301-990-7979.

    Special Testing Accommodations (or Testing in the U.S. Only)

    In adherence with theAmericans with Disabilities Act (ADA, 1990, updated 2010), NBCOT will provide reasonable

    and appropriate accommodations for eligible candidates with a diagnosed disability who submit appropriate

    documentation.

    Refer to the Special Testing Accommodations handbook at: www.nbcot.org > Forms > Special Accommodationsfor

    details on requesting testing accommodations. Direct specific questions to: [email protected]

    Please note, a request for special testing accommodations approval may increase the amount of time it takes to

    process an exam application.

    Taking the Spanish OTR Certifcation Examination

    Candidates may choose to take the OTR examination written in American Spanish. Candidates wishing to take the

    examination written in American Spanish MUST:

    Select the option to take the examination in American Spanish on the certification examination application (section

    7 of the application). Candidates who submit an exam application and later request the American Spanish

    version will be required to pay an additional fee.

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    APPrOvEd APPLICATIONSAuthorization to Test (ATT) Letter

    Once a candidates eligibility has been approved by NBCOT, the candidate will receive anAuthorization to Test (ATT)

    letter by e-mail (or regular mail, if no e-mail address was provided on the application). The ATT letter authorizes the

    candidate to take the certification examination.

    The ATT letter is active for 90 days. If the candidate does not take the examination within this 90-day period, the

    candidate may choose to reactivate the ATT letter for an additional 90 days. The ATT letter can be reactivated as

    many times as necessary during the one-year application period. There is a fee for each reactivation of the ATT

    letter. After one year, the ATT letter can no longer be reactivated a new examination application and fee MUST be

    submitted.

    Reactivation of the ATT letter may be requested online if the account is in Reactivate Status, by logging onto the

    candidates account, or by submitting a Reactivation/Reissue of Authorization to Test (ATT) Form, available on the

    NBCOT website at:

    www.nbcot.org. > Forms > NBCOT Certification Examination Forms > Reactivation/Reissue of Authorization to Test (ATT) Form.

    Once a candidate submits a Reactivation/Reissue of Authorization to Test (ATT) form, the original ATT letter is voided.

    The candidate may no longer test on the original ATT letter.

    Checking the Examination Application Status

    Candidates may log into their examination application account to check the application status by using the same

    login (e-mail and password) created at initial account setup. Candidates can check to see whether payment has

    been received, the transcript has been received (not required if the candidate has completed the OTED process),

    or the ATT letter has been sent. It is the candidates responsibility to check to see if the ATT letter has been sent to

    them online. Candidates can view and print a copy of their current ATT letter from their account. Those who do not

    have an e-mail address or password can call NBCOT and the ATT letter will be re-mailed if the ATT letter has not yet

    been received.

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    Scheduling the Certifcation Examination

    After the ATT letter has been received, candidates can schedule their testing appointment directly with Prometric.

    A list of Prometric test centers can be found online at www.prometric.com. Candidates are encouraged to locate

    a test center and schedule their examination online. If a candidate chooses to call Prometric instead, the call

    center should be contacted, rather than the individual Prometric test center. Prometrics contact information will be

    included on the candidates ATT letter. NBCOT cannot schedule or confirm individual exam appointments.

    Biometric Candidate Notice During Scheduling/Registration

    Whether scheduled online or via phone, the candidate will be presented with a biometric-enabled check-in notice.

    This notice will explain the collection and usage of biometric information. The candidate MUST acknowledge

    having read the statement by selecting agree or disagree either selection will allow the candidate to proceed with

    registration.

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    Name and/or Address Changes

    The rst and last names provided on the examination application is the name that is printed on theAuthorization To Test(ATT) letter.

    Candidates are required to present identication when arriving at the Prometric Test Center. This identication MUST match the rst and last names indicated on the ATT letter. The middle initial does

    not show on the ATT letter and is not required for ID purposes.

    If the identication does not match the ATT letter, the candidate will not be admitted to test, and theexamination will be forfeited.

    When the exam is forfeited, the ATT letter is voided; a new ATT letter is required. Name changes cannot be made at the test center.

    Name Change (First-time Candidates)

    If a candidates legal name changes AFTER the examination application has been submitted, the new nameMUST be updated with NBCOT.

    To request a name change BEFORE the exam application account is pre-approved:

    Complete a Name Change Request Form available online at:www.nbcot.org > Forms > Certication Related Forms > Misc. Forms >Name Change Request Form.

    Submit copies of the legal documentation that reects the name change. See request form for list ofaccepted documents.

    Mail or fax form and documentation to NBCOT, at the address listed on the form. The name given on the examination application is the name printed on theAuthorization To Test (ATT) letter. To request a name change AFTER the ATT letter is issued:

    Complete a Reactivate/Reissue of ATT letter Form available online at:www.nbcot.org > Forms > NBCOT Certication Examination Forms> North America > Authorization To Test Letter

    (reactivation). Be sure to include the reactivation fee.

    Submit copies of the legal documentation that reects the name change. See request form for list ofaccepted documents.

    Mail or fax forms, payment, and documentation to NBCOT, at the address listed on the form.Name Change (Retake Candidates)

    Candidates who need to retake the certication examination and who have had a legal name change sincethe last exam administration MUST contact NBCOT by telephone or e-mail for instructions prior to submitting

    the online exam application.

    Candidates do not have the ability to change their name online. If a candidate reapplies with payment prior to NBCOT updating their record, the application becomes

    pre-approved in the previous name.

    Those who reapply online PRIOR to contacting NBCOT, will be assessed an administrative fee to correct thename in the online account.

    Payment in the form of a check, money order, or credit card (Visa/MasterCard) will be required withsubmission of the Name Change Request Form and proper name change documentation to NBCOT.

    Candidates submitting paper exam applications can submit name change documentation, along with examfees to NBCOT.

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    Address Change

    When a candidates address changes AFTER the exam application has been submitted, the candidatecan update their address information at the Prometric testing center on the day of their exam, or by calling

    NBCOT when the online pass/fail scoring information has been uploaded.

    Address changes can only be made to the application BEFORE the exam application account ispre-approved/processed.

    Candidates who apply online are encouraged to access their application online to update their address. Address changes cannot be made to the online application once the ATT letter has been issued. The next opportunity to change an address is at the Prometric test center on the day of the examination. Address changes may also be made if and when an ATT letter is reactivated/reissued. Please be sure to set up a forwarding address with the postal service.

    Application Withdrawal and Reund For Personal and/or Medical Emergencies

    Candidates whose exam has been scheduled, and whom experience a personal or medical emergency, MUST notify

    NBCOT in writing. Documentation verifying the event/circumstance MUST be provided. Requests for rescheduling ofthe exam will be considered on a case by case basis.

    Approved candidates will receive a partial refund. Since the examination application remains active for one year, in

    order to receive a partial refund, the candidate MUST completely withdraw the examination application within a year

    of the application date and submit the request via e-mail to [email protected] a brief explanation. Refunds will be

    processed within 30 days from the date NBCOT approves the refund request.

    Cancellation, Rescheduling, Late Arrival or No Show or Scheduled Examination

    The following fees apply to examination candidates who reschedule, cancel, arrive late or do not appear for their

    scheduled examination:

    Category Cancellation/Reschedule Period Cancellation/Rescheduling Fee

    1 30 or more business days before scheduled examination dateNo fee. If exam is rescheduled within current ATT letter activation

    period, no Reissue/Reactivation Notice form is required.

    2 5-29 business days before scheduled examination date

    $35.00 (contact Prometrics Candidate Services Contact Center).

    If exam is rescheduled within current ATT letter activation period,

    no Reissue/Reactivation Notice form is required.

    3

    Less than 5 business days before scheduled examination date; or

    Fails to appear for a scheduled examination; or

    Arrives at the Test Center more than fteen (15) minutes after

    scheduled examination start time for taking the examination and

    is refused admission

    Arrives at the Test Center without the proper ID

    $175.00 - See NBCOT website (www.nbcot.org) for an ATT

    Reissue/Reactivation Notice order form. This form MUST be

    completed and submitted to NBCOT with payment before the exam

    can be rescheduled.

    Candidates with Category 1 or 2 changes MUST make and confirm all cancellations/changes through direct contact

    with Prometrics Candidate Services Contact Center (CSCC) personnel. Leaving a message on a recorder or a voice

    mail is NOT an acceptable means to confirm cancellation or examination date change.

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    Ofcial Score Transfer*

    Conrmation of Examination Registrationand Eligibility to Examine Notice

    Authorization to Test (ATT) Reactivation/Reissue

    Online Practice Tests

    Online Content Tests

    OTKE Study Guides

    NBCOT Ea Pocts an Seices refn Polic

    Fees for these services are non-refundable

    *Exception: If the examination application is withdrawn,the Ofcial Score Transfer fees will be refunded.

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    Examination

    The OTR examination consist of 3 Simulation Test Items and 170 Multiple Choice Test Items.

    The questions are derived from the result of practice analysis studies and developed to measure the knowledge

    required for practicing as an entry-level occupational therapist registered.

    The following chart presents the domain areas and proportion of test items established for the OTR blueprint of the

    current certification examination.

    PrEPArINg FOr ThE ExAm

    valiate doain, Task, Knolee

    an Skill Stateents fo te EainationsThere are multiple task, knowledge, and skill statements for each domain area of the credentialing

    examination. The OTR Validated Domain, Task, Knowledge and Skill Statementsfor the examination is

    available online at:

    www.nbcot.org > Certification Candidates > Certification Candidates FAQ > Where can I obtain more detailed

    information about the areas tested on the examinations?

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    Multiple Choice Items

    Each multiple choice item starts with a stem or premise. This is usually in the form of a written statement or

    question. Possible response options are listed beneath the stem. From the options listed, there is only ONE correct

    response, the other options are distracters. Candidates need to solicit the best response based on the information

    presented in the stem.

    Example: During which task would a stereognosis deficit secondary to a CVA be MOST EVIDENT?

    1) Getting coins from a pocket*2) Pouring water into a cup

    3) Putting on a pair of socks

    4) Opening a pill bottle

    *Correct answer

    Simulation Test Items

    A simulation test item consists of an opening

    scene, sections with section headers, and

    a list of decisions or action statements.

    These action statements consist of positive,

    negative, and neutral statements.

    An example is shown at right.

    Candidates select the actions that they

    deem appropriate from the list of actions

    provided. As the action statement is

    selected, a feedback box will appear.

    Feedback is revealed response-by-response

    as the candidate makes each selection, so

    that a candidate only receives information onthe actions they have chosen throughout the

    course of the problem. Feedback does not

    give information on how well a candidate did

    on the item.

    From the list of actions, a candidate will

    score points for positive actions and have

    points deducted for actions that are negative

    or hinder the resolution of the presented

    problem(s). A candidate will neither have

    points awarded nor deducted for selecting a

    neutral action.

    Once an action has been selected it cannot

    be de-selected. Candidates are able to

    navigate back to see previous screens;

    however, actions cannot be added to

    previous screens once the candidate has

    progressed to a new screen.

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    Study Tools

    NBCOT offers a number of study tools to assist candidates with their exam preparation including the validated

    domain, task, knowledge and skill statements, the examination blueprints, entry-level self-assessment tools,

    online practice tests, study guides, and study packages. The tools are designed to help candidates assess their

    examination readiness, focus study efforts in appropriate areas, and become familiar with the areas tested on

    the examination. NBCOT does not guarantee enhanced performance on the NBCOT certification examinations for

    those using any of these study materials. However, the official NBCOT study tools are the only OTR certification

    examination study tools designed exclusively by NBCOT test development professionals and include sample

    practice questions that have been written to the same psychometric standards as the actual NBCOT certification

    examinations.

    NBCOTStudy Tools Central

    To access the study tools, click on the

    Study Tools Central button atleft, or on the NBCOT home page at

    www.nbcot.org

    NOW Accessible From Mobile DevicesEnt-Leel

    Self-Assessent Tools

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    What are the requirements for admission to the test center?

    You MUST arrive 30 minutes prior to your scheduled appointment with two forms (two primary forms or aprimary and secondary form) of acceptable identication where your name and signature match your ATTletter.

    Acceptable Primary identification is:

    A currently valid, government-issued photo ID with legal name and legible signature.Primary ID Requirement Requirement Requirement Requirement

    Drivers License Current issue date Legal name Signature Photograph

    Passport Current issue date Legal name Signature Photograph

    State Issued ID Current issue date Legal name Signature Photograph

    Permanent Resident/

    Green Card Current issue date Legal name Signature/barcode Photograph

    Military ID Current issue date Legal name Signature/barcode Photograph

    Acceptable Secondary identification is:

    A current major credit card with expiration date (Visa, Master Card, American Express or Discover Card) ATM card Employee ID card Voter registration card or letter Student ID card

    Social Security cards are not accepted

    All forms of ID MUST be original and MUST have a signature. If there is a discrepancycaused by a recent name change, a copy of the marriage license/certicate or divorcedecree will NOT be accepted at the test center and you WILL NOT BE PERMITTED TO

    TAKE THE EXAMINATION refer to name change procedures on page 12.

    Will I be thumb-printed or photographed at the testing center?

    Prometric employs biometric-enabled check-in services at all its test sites. This procedure consists of a number

    of steps to verify your eligibility to test, including taking an electronic record of your ID, photo imaging, and a

    digital fingertip record. You are required to undergo fingertip analysis any time you leave and re-enter the testing

    room for validation purposes. There is video surveillance in all candidate accessible areas of the testing center.

    What items are prohibited while taking the examination?

    You are not allowed to bring ANY electronic device (cell phones, personal digital assistants (PDAs), cameras, or

    digital watches) or any hard copy documentation into the testing facility. This includes but is not limited to the

    lobby, bathroom, test administration check-in and/or waiting rooms or the test administration room. If you are

    found using such a device during any part of the test administration process, the Testing Center Administrator

    (TCA) will require you to step out of the test administration area. The TCA will inform you that you have violated

    test center rules and a report will be filed. The TCA will file a detailed Candidate Proctor Report (CPR) with

    NBCOT, including the make/model of the prohibited item (if applicable). You will be dismissed and the exam

    terminated. Your future exam eligibility status will be determined by NBCOT.

    ExAm dAy: quESTIONS & ANSwErS

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    Can I use earplugs?

    Candidates may provide their own earplugs as long as they are not connected with a string or wires. Earplugs are

    subject to inspection by the TCA. Headphones are available at all Prometric Testing Center locations.

    What clothing am I allowed/not allowed to bring into testing room?

    If you wish to wear a sweater or jacket, the clothing item MUST be donned before entering the testing room.

    Once in the testing room, you will not be allowed to put on or take off a sweater, jacket, or shoes, or pull a jacket

    hood up over your head. Head coverings of any kind are not allowed in the testing room unless it is being wornfor religious purposes (such as hats, turbans, scarves, and yarmulkes). If the item is worn for religious purposes

    it will be visually inspected prior to you being admitted into the testing room and MUST remain in full view at all

    times. If you need to reposition or take off the head covering or religious item, you will be asked to step out of the

    testing room into the waiting area.

    Do I have to request a special testing accommodation to bring a hearing aid, cochlearimplant or insulin pump into the testing room?

    If the device makes any kind of noise, the candidate must request and be approved for special testing

    accommodations in advance. If the device does not make any noise, no testing accommodation is required. All

    devices will be visually inspected prior to the candidate being admitted into the testing room. If the device needsto be readjusted after the exam has begun, the candidate will be asked to step into the waiting area.

    How much time will I have for the examination?

    The appointment time for the OTR examination is 5 hours and 15 minutes. The exam itself is only 4 hours

    long. The extra appointment time is to allow candidates to complete administrative, tutorial, survey information.

    Will there be other candidates testing at my test center?

    It is likely that there will be other candidates taking different examinations at your test center during your exam

    appointment. The layout of the testing cubicles ensures you have ample workspace and privacy from other test

    takers.

    Can I take a break during the examination?

    Yes, you may take breaks during the examination. However, the exam clock will continue to run while you are

    on the break. You will be required to complete all check-in procedures to re-enter the testing room. This may

    require waiting for other exam candidates to complete check-in procedures.

    Is computer knowledge necessary?

    No. The optional tutorial(s) that accompany the examinations walk you through the process of selecting answers

    and progressing through the examination on the computer. Tutorial time does not count towards your allotted

    examination time. You can repeat the tutorial(s) if you wish.

    Can I Make Notes During the Exam?

    You can request to use a wet marker board from the TCA during your examination. If you require additional

    materials, you will need to wait for the TCA to clean the originally issued wet marker board before reusing.

    Can I eat/drink in the testing room?

    No; however, beverages and snacks can be stored in lockers located in the testing center waiting area.

    Candidates may eat or drink in the waiting area only.

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    What can I do if the computer malfunctions while taking the exam?

    You MUST alert the TCA immediately. Staff will make every effort to remedy the situation as soon as possible.

    The time spent to remedy the problem will not count as part of your examination time. Due to the nature of the

    exam delivery system, no previously entered examination data can be lost. If the problem cannot be remedied

    within 30 minutes, you have the right to reschedule the examination for another day within your eligibility period.

    What happens if I experience an administrative or technical issue during my exam?

    Examples of administrative or technical issues include: computer screen freezing, power failure, approved

    accommodations not being available, excessive noise or physical disruption within the testing center, or test

    not available at scheduled time. You MUST file a complaint immediately with the TCA or before leaving the test

    center and you MUST request a ticketnumber. You MUST ALSO contact NBCOT by e-mail within 24 hours after

    the incident occurred and provide NBCOT with the ticket number and case summary. Administrative or technical

    complaints MUST be e-mailed to [email protected]. NBCOT will confirm receipt of the complaint.

    What is my obligation to maintain confidentiality after I take the exam?

    The NBCOTs certification examinations and the items contained therein are protected by federal copyright

    law. No part of an examination may be copied, reproduced, or shared in any manner, in part or whole, by any

    means whatsoever, including memorization, verbal, written, and/or electronic transmission which includes but

    is not limited to (e.g., Facebook, Twitter, cell phone, blogs, discussion forums). Posting examination or study

    tool questions to social media or other networking sites constitutes a test security and copyright violation as

    noted in Principle 1 of the NBCOT Candidate/Certificant Code of Conduct. Infringements of the NBCOT Code of

    Conduct are investigated by the NBCOTs Qualifications and Compliance Review Committee (QCRC) to determine

    appropriate disciplinary action.

    wat to Bin to te Ea: Twofos of ientification: First and last names on IDs MUST match name on ATT letter

    One must be government-issued photo ID with signature Signatures on BOTH ID documents must be CLEAR

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    How are the exams scored?

    Each administration of the NBCOT certification examinations is designed to fairly assess the knowledge

    required for entry-level practice. The total raw score (the total number of correct responses) is converted to a

    scaled score ranging from 300 to 600 points. To ensure scores on different forms of the examination havethe same meaning, raw scores are converted to scaled scores representing equivalent levels of achievement

    regardless of the form of examination taken. The NBCOT minimum passing scaled score is 450. For more

    information on scoring, please refer to the Foundations of the NBCOT Certification Examinations, which can be

    accessed at www.nbcot.org > Publications > Foundations of the NBCOT Certification Examinations.

    How will I get my examination result?

    After the administration of the examination, your examination will be scored by NBCOT. You should refer to the

    NBCOT scoring calendar for the exam scoring schedule and dates. The scoring calendar can be accessed at

    www.nbcot.org > Certification Candidates > Scoring Information > Exam Scoring Calendar.

    You can view your unofficial pass/fail status through your online account after the exam has been scored

    usually within two to three days after the scoring date.

    The official score report is mailed within four (4) weeks of taking the examination. If you do not receive your

    score report within four to six (4-6) weeks of taking the examination you should submit a Duplicate Score Report

    Request. Duplicate score reports are provided at no cost if submitted within 4-6 weeks after taking the exam.Beyond six (6) weeks, the Duplicate Score Report Request FormMUST be accompanied with the appropriate

    fee. The form can be accessed at:

    www.nbcot.org > Forms > NBCOT Certification Examination Forms > North America > Duplicate Certificate Request Form.

    AFTEr ThE ExAm: quESTIONS & ANSwErS

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    Passing Candidates will receive by mail a congratulatory letter

    that includes the total scaled score on the examination, an

    official NBCOT certificate and wallet card, and the Credentials

    Essentials Toolkit.

    Upon receipt of the score report, candidates who hold a state-

    issued limited or temporary permit(s) or license(s) which

    allows them to practice are advised to immediately contact theregulatory agency in that jurisdiction to determine whether their

    limited or temporary permit/license remains valid. Since the

    laws and regulations of each jurisdiction vary, it is essential that

    the regulatory agency is contacted directly.

    Failing candidates will receive a score report that includes the total scaled score, along with performance

    information for each domain area of the examination. The information on the domain areas is provided

    for diagnostic purposes only. The score report will include information about how to register to retake the

    examination (see retaking the examination section on page 23 for more details).

    Can I Appeal My Examination Result?Yes, you may appeal your examination result; however, failing the examination alone is not sufficient grounds for

    an appeal. The appeal MUST be submitted in writing to NBCOT and MUST specifically state the reason(s) for the

    appeal, and why the appeal should be granted. Appeal letters should be sent to NBCOT by traceable mail signature

    of receipt required to:

    NBCOT Managing Director, Competency Assessment

    12 South Summit Avenue, Ste 100

    Gaithersburg, MD 20877

    The appeal letter MUST be received by NBCOT within 14 days of receipt of the online examination pass/fail results.Correspondence received after this date will not be accepted. NBCOT will provide a response to the candidate

    regarding the outcome of the appeal within 21 days of receipt of the appeal letter.

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    Any candidate who fails the examination may apply for another examination administration. The re-application

    process is the same as the initial application process. Detailed instructions can be found in the candidates scorereport. When re-applying, the following should be noted:

    There is a 45-day waiting period after the last examination date before the candidate may test again. The candidate MUST submit a new application in order to re-test. Instructions will be provided in the

    candidates score report.

    If the candidate has had a name change since the last exam administration, the candidate MUST followthe instructions on page 12, Name Change (Retake Candidates), before submitting an application for the

    certication examination. Failure to do so could result in an administrative fee to correct a name on theAuthorization to Test (ATT) letter.

    If re-applying online, the candidate should log onto their online account, using the e-mail address andpassword selected during initial account set up. A new account should not be created. A fee will beassessed for duplicate accounts. After logging on, click the Re-Applybutton.

    A new application fee will be assessed. New fees will also be assessed for score reporting, conrmationnotices, or any other services.

    After eligibility has been approved, the candidate will receive a new ATT Letter, with a new 90-day testing eligibility

    period.

    rETAKINgThE ExAmINATION

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    Upon initial NBCOT certification, the credential is valid for a period of three (3) years. Certification renewal is

    required to maintain active certification.

    The requirements for certification renewal are:

    a completed Certication Renewal Application the appropriate renewal application fee accrual of required Professional Development Units (PDU): certicants accrue 36 PDU in the three (3) years

    between their initial certication date and the renewal due date

    abidance by the NBCOT Candidate/Certicant Code of ConductFulfilling the certification renewal requirements entitles a certificant to continue using the OTR credential.

    Why Renew?One of the best values of certification renewal is the continued use of the NBCOT credential. The OTR credential is

    representative of practitioners who satisfy national standards in education, experience, and professional conduct,

    and demonstrate that they possess the knowledge and skills to be accountable for the delivery of professional

    services. In a recent NBCOT survey(1), certificants identified the top reasons for maintaining certification as

    recognition of:

    How to Renew Certifcation

    There are two ways to renew certification:

    1. Submit an online application at www.nbcot.org

    2. Complete and mail in a hardcopy application

    Prior to a certificants renewal due date, NBCOT sends a courtesy reminder notification and renewal instructions. For

    this reason, it is essential that the certificant maintain their current contact information with NBCOT, including e-mail

    address. Upon renewal, all certificants receive an updated certificate and wallet identification card.

    NBCOT CErTIFICATION rENEwAL:KEEP yOur CrEdENTIAL ACTIvE!

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    Summary of Exam Candidate RequestsService Request Service Requirements

    Page

    Reference

    Name change before ATT letter is

    issued (rst-time candidate)

    Complete Name Change Request Form and submit with copies of

    government issued IDs reecting your name change, i.e., drivers license,state issued ID or passport.

    12

    Name change after ATT letter is

    issued (rst-time candidate)

    Complete Reactivation/Reissue of Authorization To Test (ATT) Letter Form,with fee, and copies of government issued IDs reecting your name change,i.e., drivers license, state issued ID or passport.

    12

    Name change (retake candidate)

    Must contact NBCOT by telephone or e-mail for instructions prior to

    submitting online exam application; if candidate applies online prior

    to contacting NBCOT, administrative fee is assessed to correct online

    application.

    12

    Retake examination candidatesThere is a 45-day waiting period after the last examination date before the

    candidate may test again.23

    Mailing address change

    New address changes can only be made to application before the ATT letter

    is generated. New address must be updated on exam application. Once ATT

    letter is issued, the next opportunity to change address will be at PrometricTest Center on day of exam. Address changes may also be made if/when an

    ATT letter is reactivated/reissued.

    13

    E-mail address change

    Online candidates must provide a valid (working) e-mail address that is

    capable of receiving e-mail from NBCOT. It is candidates responsibility

    to keep e-mail address current with NBCOT. Candidates can update

    their e-mail address by contacting NBCOT customer service via e-mail at

    [email protected].

    6

    Reactivation of ATT letter

    ATT letter is active for 90 days. If candidate does not take exam within the

    90 day period, the ATT letter can be reactivated for additional 90 days.

    An additional fee is required. Reactivation of ATT letter may be requested

    online, by logging onto the candidates account, or by submitting the

    appropriate form available on the NBCOT website.

    12

    Exam score report request to state

    regulatory boards (prior to exam

    application being approved)

    Request when submitting exam application. A fee for each state is required. 8-9

    Exam score report request to state

    regulatory boards (after the exam

    application has been approved)

    Complete Ofcial Score Transfer Request Form (available at www.nbcot.

    org). A fee for each state is required. Increased fee after exam application

    has been submitted.

    8-9

    Conrmation of Exam Registrationand Eligibility to Examine Notice

    Request (prior to submitting exam

    application)

    Request when submitting exam application. A fee for each state is required. 8-9

    Conrmation of Exam Registrationand Eligibility to Examine Notice

    Request (after submitting exam

    application)

    Complete Conrmation of Exam Registration and Eligibility to Examine

    Notice Request Form (available at www.nbcot.org). A fee for each state is

    required.

    8-9

    If an exam candidate has been

    charged with and/or convicted of

    a felony at any time before or after

    issuance of an Authorization To Test

    (ATT) letter

    Based on Candidate/Certicant Code of Conduct (candidate must agree

    to when signing exam application attestation statement), candidate must

    notify NBCOT of felony charge and/or conviction. If candidate fails to inform

    NBCOT, disciplinary action may result.

    7

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    Examination Application Procedures Checklist ................ A

    2013 Certication Examination Application ..................... B

    CONTENTS

    APPENdIx

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    Completing the NBCOT Examination Application and Submitting Fees:

    I have read the NBCOT Certication Examination Handbook for internationally educated candidates.My occupational therapist eligibility determination (OTED) application is complete, and I have been

    approved by NBCOT to submit an examination application.

    If applying online for the rst time, I have set up a new account with my valid/working e-mail address(username) and password. If I have an existing online application account, I have logged on with my

    username and password and then I have clicked on the Re-Applybutton.

    If applying with a paper application, I have submitted payment by mail to the NBCOT lockbox address (refer

    to exam application).

    If I want NBCOT to send an Ofcial Score Transferor Conrmation of Examination Registration and

    Eligibility to Examine Notice to a regulatory entity or employer, I have indicated so on my application.

    If applying online, I have printed out the receipt/invoice for my records as proof of successfully submittingthe application. If submitting a paper application, I have made a copy for my records.

    I have paid all applicable fees.

    If I have had a name change at any time prior to taking the certication examination, I have sent to NBCOTa Name/Address Change Request, the appropriate legal documentation, and fee if applicable.

    Option to take the Spanish OTR Exam

    If I wish to take the Spanish OTR exam, I have completed the following:

    Indicated my intent to take the Spanish OTR exam on the exam application.

    Submitted the exam application and payment to NBCOT.

    Scheduling with Prometric

    I have contacted the Prometric Call Center to schedule my appointment. Note: An examination date cannot

    be scheduled without an ATT Letter.

    If I need to cancel/reschedule my examination date, I will follow the procedures outlined in the

    cancellation policy.

    ExAmINATION APPLICATIONPrOCEdurES ChECKLIST

    Appeni A

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    I am a graduate from a program: within the U.S. or its territories outside the U.S.

    I am a: rst-time applicant repeating test-taker

    Date of Birth:

    First Name:

    Middle Name:

    Last Name:

    Mailing Address:

    City:

    State/Province:

    Postal Code: Country:

    Phone:home work mobilePhone:home work mobileSocial Security Number:If no SSN, skip to next line and provide Student ID#.

    Student ID Number:

    This is the number assigned by school for U.S. graduates; assigned by NBCOT for OTED approvals(including internationally-educated).

    E-mail Address (must be active):

    Choose a Password:This password can be used to check your application status online.

    Gender: MaleFemale

    Ethnicity:

    American Indian or Alaskan Native

    AsianBlack or African AmericanHispanic/Latino of any race

    Multi-racialNative Hawaiian or Other Pacic IslanderWhite

    Age: under 21 21-25 26-29 30-39 40 or above

    2013 Certifcation ExaminationApplication

    OTR and COTA

    Section 1: Applicant Inormation

    Section 2: General Inormation (optional)

    ID 33 rev12061

    Appeni B

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    Exam Level: CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTAOCCUPATIONAL THERAPIST REGISTERED OTR

    U.S. School Name*:

    U.S. School Code*: Graduation Date (mm/yyyy):

    *available online at www.nbcot.org/pdf/US-School-Codes.pdf

    OTR Credential:

    COTA Credential:

    Entry-Level Masters DegreeEntry-Level Doctoral DegreeOTED (including internationally educated)Associate DegreeCerticate

    Educational Program Director Requests

    In the event that my education program director requests my certication examination score, I hereby grant permissionto release my score. Please check one:

    Yes, I grant permission to release my score to my education program director upon their request.No, I prefer not to release my score.

    HAVE YOU EVER...

    been charged with or convicted of a felony? (NOTE: Certicants must answer afrmatively if records,charges, or convictions have been pardoned, expunged, released or sealed.)

    YesNohad any professional license, registration, or certication denied, revoked, suspended, or subject toprobationary conditions by a regulatory authority or certication board?

    YesNobeen found by any court, administrative, or disciplinary proceeding to have committed negligence,

    malpractice, recklessness, or willful or intentional misconduct which resulted in harm to another?YesNo

    been suspended and/or expelled from a college or university? YesNoIf you answer yes to any of the character questions, please refer to page 7 of the handbook for further detail

    regarding documentation requirements.

    All documentation must be submitted to and reviewed by NBCOT before the examination application will be

    approved.

    Mail documentation to:

    NBCOT, Inc.; Attn: Qualifications and Compliance Review12 South Summit Avenue, Suite 100Gaithersburg, MD 20877

    Exam Eligibility Pathway:

    Name:

    Section 3: Credential Inormation

    Section 4: Character Questions

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    By submitting this exam application, you are attesting to having read and understood the following NBCOT

    Certicant Attestation Statement and the information provided in the NBCOT Certication Examination Handbook.

    Please read this statement carefully.

    I have read, understand, and agree to adhere to the provisions of the current edition of the NBCOT Certification

    Examination Handbook, the NBCOT Candidate/Certificant Code of Conduct (hereinafter referred to as the Code of

    Conduct), and the NBCOT Procedures for Enforcement of the NBCOT Code of Conduct (hereinafter referred to as the

    Procedures), all of which can be found on the NBCOT website at www.nbcot.org. By signing below, I am attestingthat I have personally completed the exam application and that the information I submit in the application myself

    and in any required accompanying or subsequent documentation is true and accurate to the best of my knowledge.

    Additionally, I understand that persons who apply for certification as an OCCUPATIONAL THERAPIST REGISTERED

    OTR or CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA or persons who have been certified by NBCOT, are

    subject to the Code of Conduct and the Procedures. I understand that from time-to-time NBCOT may amend its

    requirements, policies, and procedures for initial certification, certification renewal, and Procedures for Enforcement

    of the Code of Conduct. During my three-year certification cycle, I agree to notify NBCOT in writing of any violation

    of the Code of Conduct (e.g. felony charge and/or conviction, suspension, or revocation of a license to practice

    occupational therapy).

    I agree to hold NBCOT, its directors, officers, employees, and agents free from any damage or complaint by reason

    of any action taken in connection with the score or score given with respect to this or any other NBCOT certificationexamination, or the failure of NBCOT to issue me certification. I understand that if it is confirmed I was not eligible

    at the time I examined, my examination score will be voided. If it is ever determined that I was a participant in

    any testing irregularity, such as use of any electronic device during the examination and/or break, or cheating,

    to include discussing, transmitting or copying a test item(s) or answer(s) to a third-party, before, during or after

    the examination, my certification or eligibility status with NBCOT may be changed. Further, I understand that if I

    need to file an examination administrative or technical complaint that I must file such a complaint on-site at the

    Prometric Test Center, and must request a ticket number. I also agree to notify NBCOT in writing of any address

    and/or name change within thirty days (30) after the change becomes effective. If requested to do so, NBCOT may

    verify my certification status. I hereby consent to NBCOTs release of any information regarding this application,

    my examination eligibility, my examination administration, or my certification status to any academic institution,

    employer, regulatory agency, or other party that may inquire in writing.

    I understand that NBCOT reports aggregate school performance data to all occupational therapy education programs

    and to the Accreditation Council for Occupational Therapy Education, (ACOTE) on an annual basis.

    Signature: Date:

    Please print name here:

    I am requesting Special Testing Accommodations for the certication examination, due to a documented disability.Please submit a completed Special Testing Accommodations Application with supporting documentation

    to NBCOT. The handbook and application can be found online at www.nbcot.org.

    I am reapplying for the certication examination, and am requesting identical accommodations previouslyapproved by NBCOT.

    If you were approved to take the exam with accommodations prior to 2010, you may be required to

    submit updated documents.

    I am reapplying for the certication examination, and am requesting different or additional accommodations.Please submit a completed Special Testing Accommodations Application with supporting documentation to NBCOT.

    The handbook and application can be found online at www.nbcot.org.

    Name:

    Section 5: Application Acknowledgement and Attestation Statement

    Section 6: Special Testing Accommodations - For Testing in the U.S. Only

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    Candidates may choose to take the OTR or COTA examinations written in American Spanish. If you wish to take the

    certification examination in American Spanish examination you MUST check one of the following:

    I wish to take the OTR examination written in American SpanishI wish to take the COTA examination written in American Spanish

    Please send a Confirmation of Examination Registration and Eligibility to Examine Notice to the following third

    parties. I have included the $45 fee for EACH notice requested. Please Note: When a confirmation notice is

    requested for a third party, the candidate will receive a copy at no extra charge. Fees for confirmation notices are

    non-refundable.

    To State Regulatory Boards:

    Please Note: ONLY the states listed below accept confirmation notices.

    Alaska Idaho Montana Oklahoma UtahArizona Illinois Nebraska Oregon VermontArkansas Indiana Nevada Pennsylvania VirginiaCalifornia Kentucky New Jersey Puerto Rico West VirginiaDelaware Maine New Mexico Rhode Island WyomingDistrict of Columbia Maryland New York South DakotaFlorida Massachusetts North Dakota TennesseeGeorgia Missouri Ohio TexasTo Employers and Other Third Parties:

    Attn:

    Company Name:

    Address:

    City: State: Postal Code/Zip:

    Name:

    Section 7: Option to Take the Spanish OTR or COTA Certication Examination

    Please send an Official Score Transferto the jurisdiction(s) selected below. I have included the $40 fee for EACH

    score report. Please Note: No state will receive a report unless it is marked here and the additional payment for

    EACH state marked is enclosed. Fees for score reports are non-refundable. ONLY the states listed below accept

    score reports.

    Alabama Idaho Minnesota North Dakota UtahAlaska Illinois Mississippi Ohio VermontArizona Indiana Missouri Oklahoma VirginiaArkansas Iowa Montana Oregon WashingtonCalifornia Kansas Nebraska Pennsylvania West VirginiaColorado Kentucky Nevada Puerto Rico WisconsinConnecticut Louisiana New Hampshire Rhode Island WyomingDelaware Maine New Jersey South CarolinaDistrict of Columbia Maryland New Mexico South DakotaFlorida Massachusetts New York TennesseeGeorgia Michigan North Carolina Texas

    Section 9: Ofcial Score Transer

    Section 8: Confrmation o Examination Registration and Eligibility to Examine Notice

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    Name:

    Section 10: Fees and Payment or Paper Applicants

    Examination Application/Study Tools

    NBCOT offers a number of study tools to assist candidates with their

    exam preparation including online tools, practice tests, and study guides.

    Visit www.nbcot.org> Study Tools Central

    for more information.

    NBCOTApplication Payment

    Name:

    Street Address:

    City:

    State/Province: Postal Code:

    Country:

    Phone:

    E-mail:

    Credit Card Number:

    Expiration Date: 3-digit CVV code:

    Credit Card Holders Name:

    Card Holders Address (required):

    I authorize the amount indicated above to be charged

    to my credit card.

    Signature of Cardholder (required)Payment:

    Check Money Order Visa MasterCardPlease make checks and money orders payable to NBCOT.

    Checks must be drawn on a U.S. bank.

    Mail completed application, signed attestation, any requireddocumentation and payment together in one envelope, to:

    NBCOT, Inc.

    P.O. Box 64971

    Baltimore, MD 21264

    Each Qty. Amount

    Online Application Fee $500 x =

    Paper Application Fee $540 x =

    Ofcial Score Transfer $40 x =

    Conrmation Notice $45 x =

    Total Payment=

    Service Fees:

    Examination Application Fee $500 (online application)

    $540 (paper application)

    Official Score Transfer Request $40 per score report

    Confirmation of Examination

    Registration and Eligibility Notice $45 per notice

    Returned Check Fee $35

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    2013 National Board for Certication in Occupational Therapy Inc