Application: Start

License Information

Please read the Requirements and Instructions Page. Reading the page will assist you in the application process and may prevent delays in the issuance of your license or limited permit.

A copy of the Law and Rules are available from the Board office. If you need a copy of the form you may download the form.

OTA's please have your Substantiation of Supervision form ready to upload prior to beginning the application process. There will be a place to upload the form. If you need a copy of the form you may download the form.

Limited Permit holders please have your Substantiation of Supervision form ready to upload prior to beginning the application process. There will be a place to upload the form. If you need a copy of the form you may download the form.

The Self-Assessment is a Juris Prudence Exam over the laws and rules governing OT Practice in ND. It is 20 questions and is open book. This is not required for those applying for a license by reciprocity from another state. The JP Exam is online and must be submitted after you have finished submitting your online application to the board office. You will find the link to the Juris Prudence Exam listed in the Application for Licensure section.

Please have your References form ready to upload prior to beginning the application process. There will be a place to upload the form. If you need a copy of the form you may download the form.

Please have a copy of your test scores verifying you passed the NBCOT examination prior to beginning the application process. There will be a place to upload the information.

I am applying for a

Occupational Therapist

Occupational Therapy Assistant

Type of license

Initial License- (You have never been licensed in another state, or you do not currently hold a license in another state.)

Limited Permit plus License (Requires that you graduated from a OT/OTA program in the last 4 months and have not yet taken the examination.)

Reminder you may not practice until you have filed the limited permit of Substantiation of Supervision form.

License by Reciprocity - (Currently licensed in another state with similar license requirements. You must submit the following.)

Military Service


Are you active military?	Yes	No


Are you the spouse of an active member of the military?	Yes	No


Are you coming to North Dakota on military orders?	Yes	No

Applicant Information

Please complete the information below. Your name should be entered how it is to appear on your license.


First Name	Middle Initial	Last Name	Suffix
Social Security Number		Date of Birth	Gender
Maiden Name		Phone Number	Email

Home Address


Address		County
City	State	ZIP Code

Employer Information


If not currently working as an OT/OTA, what was the end date of your last employment as an OT/OTA?
Employer Name
Employer Address
Employer City	Employer State	Employer ZIP Code
Employer Phone Number	Employer Phone Extension	Employer County
Position		First Day of Work

Employment Setting


Academic	Hospital
Clinic/Private Practice	Long-Term Care Facility
Community-Based Care	Work and Industry
Home Care	Unemployed/Not Practicing in OT field

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