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Kentucky Board of Licensure for Occupational Therapy

Board of Licensure for Occupational Therapy
Applications and Forms

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Note: The documents on this page are in Adobe Acrobat (PDF) format. Please click on the following link to download a free copy of Adobe Acrobat Reader.

Please be advised that these documents will allow you to type in your information, print, and mail.  They will not allow you to save your document, so remember to keep a copy for your own files.

 

 Forms Library

 
  
  
  
  
Annual OT OTA Renewal Application.pdf
  
108 KB 5/7/2015 11:34 AM
Application for Continuing Education Program Approval for Course Providers.pdf
  
27 KB 5/3/2011 11:41 AM
Application for License Verification.pdf
  
45 KB 3/28/2013 10:29 AM
DPAM Course, Workshop or Seminar Provider Approval Application Form.pdf
  
163 KB 5/7/2015 11:34 AM
DPAM Specialty Certification Application.pdf
  
254 KB 5/7/2015 11:34 AM
DPAM Specialty Certification Supervisor Application.pdf
  
441 KB 5/7/2015 11:34 AM
Form to File a Complaint.pdf
  
12 KB 5/3/2011 11:40 AM
Mailing List Request.pdf
  
103 KB 1/2/2013 1:52 PM
Name-Address Change Form.pdf
  
50 KB 12/5/2014 3:48 PM
Open Records Request.pdf
  
35 KB 6/4/2012 10:05 AM
OT Complaint Form.pdf
  
188 KB 6/28/2013 3:22 PM
OTA-L Application Form.pdf
  
326 KB 5/7/2015 11:33 AM
OT-L Application Form.pdf
  
147 KB 5/7/2015 11:33 AM
Reinstatement Application for Licensure as an Occupational Therapist.pdf
  
101 KB 5/7/2015 11:28 AM
Reinstatement Application for Licensure as an Occupational Therapy Assistant.pdf
  
101 KB 5/7/2015 11:28 AM
Supervision Audit Checklist Form.pdf
  
98 KB 2/8/2012 9:14 AM
Supervision Temporary Permit Form.pdf
  
126 KB 5/7/2015 11:30 AM