OT Forms

Faxes not accepted.

Make out checks to ECPTOTE and mail to: ECPTOTE, 1801 Congress Ave Ste 10.900, Austin, TX 78701.

Note: Changes that went into effect June 1, 2019 removed certain requirements for OTAs with a regular license, including removing the requirement that OTAs with a regular license maintain a supervision log and that they submit the OTA supervision form and information regarding changes in supervisor. Refer to a related link under “Additional Resources” from the OT Act and Rules page for further information.

OT CE Submission Form (pdf): For use by those who are renewing online late with late CE

Change Your Contact Info

Consumer Information Sign (pdf)

OT/OTA Date of Birth Statement (pdf)

Employment History (pdf)

Independent Study (pdf): Optional form that may be used by those completing an independent study for CE

Mentorship Agreement (pdf): Optional form that may be used by those completing a mentorship experience for CE

OT/OTA Application for Initial Licensure (pdf)

OT/OTA Inactive Status to Active Status Form (pdf)

OT/OTA License Renewal Form (pdf)

OT/OTA Military Initial Licensure Fee Waiver Request (pdf)

OT OTA Retired Status Application/Renewal Form (pdf)

OT/OTA Retired Status to Active Status Form (pdf)

OT/OTA Temporary License Application (pdf)

OT/OTA Re-Exam Form (pdf)

Replace a License (includes with Name Change) – Select the “Replace a License” link from the Looking For? menu

Restoration of an OT/OTA License Form (pdf)

SSN Statement (pdf)

Temporary OTA Licensee Supervision Log (pdf) To be used by temporary OTA licensees only

Temporary Occupational Therapist Licensee Supervision Record (pdf): To be used by temporary OT licensees only

Temporary OT/OTA License Supervision Form (pdf): To be used by temporary licensees or those applying for a temporary license