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.

Update: The Board has just learned that HHSC has changed the link to its page with the list of approved human trafficking training courses. Until further information is available/until this message has been removed, see the link below to access such. Note that this change has not yet been made in the applications below that include the link. See the link below for the current link.
https://www.hhs.texas.gov/services/family-safety-resources/texas-human-trafficking-resource-center/health-care-practitioner-human-trafficking-training

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

CE Audit Response Form (pdf): For use by those notified that they were randomly selected for the OT Audit

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