Close Menu

Application for Licensure Instructions & Supporting Documentation

Apply online now!

Go to MyLicense.IN.gov and you will either need to create or login to your Access Indiana, single sign-on account. You will complete the online application and submit payment with a credit or debit card. You will be contacted by a customer service representative with details of what additional documentation is required to complete your application. Applications are processed in the order received.

Application Instructions:

1. Submit an application online with the application fee of $100.00. The paper application is available if necessary.

2. An official (certified) transcript of grades from the school from which the occupational therapist or occupational therapy assistant obtained his or her degree that shows the degree conferred. Graduates of a foreign occupational therapy program must submit an official translation if the transcript is not in English. This must be sent directly from the school (e-transcripts accepted to pla14@pla.in.gov.)

3. Certified copy of Diploma or an original letter from the school indicating the applicant has completed the degree and has graduated (graduation date must be listed) and this letter must be signed by the program director/dean of program. The letter must have an original signature or the school seal if it’s a stamped signature and may be uploaded at MyLicense.IN.gov using the License Update feature in your account.

4. Criminal Background Check – all applicants must obtain a criminal background check prior to being issued a license or temporary permit. For information please go to the criminal background check link on the main page of this profession. Please note that you must wait until you have been notified by us that we have received your application before you obtain your criminal background check. If it is received prior to the date we received your application we will not be able to accept it and you will be required to do it again.

5. A copy of a marriage certificate or an official affidavit indicating any legal name change, if your name differs from that on any documents. This may be uploaded with your application or using the License Update feature in your account after submitting your application online.

6. Score report submitted directly to the Committee from NBCOT.

7. If you answered “yes” to any questions on your application, explain fully, including all related details in a signed, written statement. Include the violation, location, date, and disposition.

8. Endorsement applicants: Verification of state licensure must be completed by every state where you hold or have held a license or certification. This form needs to be submitted to the Indiana Occupational Therapy Committee by the state in which you hold or have held a license or certification. If necessary, please feel free to use the form below to submit your request from each state you hold a license.

9. Temporary applicants: You must submit your application for full licensure first, and then submit your application for the temporary permit with the $50.00 application fee.

10. Temporary applicants:  You must submit your Affirmation of Supervision form.

A person with a temporary permit may only practice occupational therapy or occupational therapy assisting under the direct supervision of an Indiana certified occupational therapist that is responsible for the patient.

Verification of State Licensure Form
- May be submitted to states that you hold or have held any health profession license so that they can verify that license to Indiana. You may want to contact the state(s) prior to sending this; they may not need this form.

Application for Sponsorship as a Continuing Education Provider for OT's and OTA's 

PLEASE NOTE: Applications and documentation will not be returned to you. Fees are not refundable.