Certification
Exam Handbook
Page 2
NBCOT Certification Exam
Handbook
NBCOT® certification programs are accredited by the National Commission for Certifying Agencies (NCCA) under their
Standards for the Accreditation of Certification Programs.
NBCOT has also been awarded accreditation by the International Accreditation Service (IAS) for demonstrating
compliance with ISO/IEC Standard 17024:2012, Conformity Assessment – General Requirements for Bodies Operating
Certification of Persons.
NBCOT does not discriminate against any individual because of race, ethnicity, gender, age, creed, disability, religion, marital
status, sexual orientation, or national origin. NBCOT reserves the right to amend the procedures outlined in this handbook. All
documentation submitted to NBCOT, for any reason, becomes the property of the organization. This includes but is not limited to:
certification eligibility, initial certification, certification renewal, reinstatement, disciplinary action, international regulatory aairs
or other NBCOT matters. For the most up-to-date information/announcements concerning NBCOT certification, please visit www.
nbcot.org or contact us via phone at: 301-990-7979.
AOTCB/NBCOT Exams ID 40 rev042424 v24r4
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any
means (electronic, mechanical, photocopying, recording, or otherwise) without prior written permission of the copyright owners.
©2024 National Board for Certification in Occupational Therapy, Inc.
‘NBCOT
®
’ is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.
‘OTR
®
’ is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.
‘COTA
®
’ is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.
All marks are registered in the United States of America.
National Board for Certification in Occupational Therapy, Inc.
One Bank Street, Suite 300
Gaithersburg, MD 20878
https://www.nbcot.org
ACCREDITED
NCCA BY ICE
CERTIFICATION PROGRAM
Page 3
Table of Contents
Introduction ............................................ 6
About NBCOT ........................................ 6
About This Handbook ............................... 6
Purpose of the Exams ............................... 6
Exam Development ................................. 7
Exam Administration ................................ 7
NBCOT Candidate/Certificant Code of Conduct .. 7
Exam Certification Eligibility Requirements ........ 9
Eligibility Requirements ............................ 9
Eligibility Appeal Process ......................... 10
Application Process ................................. 10
Submitting the Application ....................... 10
Character Review .................................. 13
Testing Accommodations ......................... 14
14
Transcript Requirements .......................... 14
SENDING YOUR OFFICIAL FINAL TRANSCRIPT ....... 15
15
DEGREE VERIFICATION POLICY ........................ 15
Reporting Services ................................. 16
SCORE TRANSFER ....................................... 16
ELIGIBILITY CONFIRMATION NOTICE ................. 17
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PROGRAM PREFERENCES ..............................17
FEES ........................................................ 17
Approved Applications .............................. 18
Authorization to Test (ATT) Letter ................ 18
Scheduling the Certification Exam ............... 19
BIOMETRIC CANDIDATE NOTICE DURING
19
NAME AND ADDRESS CONSIDERATIONS AND
CHANGES ................................................. 19
RE FUN D PO LICY .......................................... 20
APPLICATION WITHDRAWAL .......................... 21
CANCELLATION, RESCHEDULE, LATE ARRIVAL,
NO SHOW POLICY ....................................... 21
Preparing for the Exam .............................. 21
Exam ................................................. 21
OTR DOMAIN DESCRIPTIONS .......................... 21
COTA DOMAIN DESCRIPTIONS ........................ 22
VALIDATED DOMAIN, TASK, AND KNOWLEDGE
STATEMENTS ............................................. 22
FORMAT OF TEST ITEMS ON THE EXAMINATIONS ... 22
HIGHLIGHT, STRIKE OUT, AND OTHER FEATURES ... 24
Study Tools: NBCOT Aspire® ..................... 24
NBCOT EXAM STUDYPACK® ........................... 24
NBCOT STUDY GUIDE ................................... 24
NBCOT FLASHCARDS .................................. 25
KNOWLEDGE MATCH GAME ........................... 25
NBCOT PRACTICE TESTS ............................... 25
Page 5
Exam Day: Questions & Answers ................... 26
After the Exam: Questions & Answers ............. 30
Retaking the Exam .................................... 32
NBCOT Certification Renewal: Keep Your
Credential Active .................................... 33
Why Renew? ....................................... 33
NBCOT Navigator® ................................ 34
How to Renew Certification ...................... 34
Summary of Exam Candidate Service Requests .. 34
Exam Application Procedures Checklist .......... 35
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Introduction
About NBCOT
The National Board for Certification in Occupational Therapy, Inc. (NBCOT
®
) is the national certification body
for occupational therapy professionals in the United States.
NBCOT strives to serve the public interest in its diversity by advancing just, equitable, and inclusive
client care and professional practice through evidence-based certification practices and the validation
of knowledge essential for eective and safe practice in occupational therapy. NBCOT’s vision is certified
occupational therapy professionals providing just, equitable, inclusive, and eective evidence-based
services across all areas of practice worldwide.
Currently, 50 states, Guam, Puerto Rico, and the District of Columbia require NBCOT initial certification for
occupational therapy state regulation (e.g., licensing).
NBCOT certification programs are accredited by the National Commission for Certifying Agencies (NCCA)
under their Standards for the Accreditation of Certification Programs. NBCOT has also been awarded
accreditation by the International Accreditation Service (IAS) for demonstrating compliance with ISO/IEC
Standard 17024:2012, Conformity Assessment – General Requirements for Bodies Operating Certification of
Persons.
• Visit NBCOT on Facebook facebook.com/NBCOTCertification
• Visit NBCOT on Instagram instagram.com/nbcot
• Visit NBCOT on Twitter twitter.com/NBCOT
• Visit NBCOT on LinkedIn linkedin.com/company/nbcot
• Visit NBCOT on YouTube youtube.com/@NBCOTCertification
About This Handbook
This handbook provides exam candidates with detailed information and steps to successfully complete and
submit a certification exam application. NBCOT recognizes the responsibility exam candidates assume when
completing their exam application.
Purpose of the Exams
The primary purpose of the NBCOT certification exams is to protect the public interest by certifying only
those candidates who have the necessary knowledge of occupational therapy to practice. The Occupational
Therapist Registered (OTR®) and Certified Occupational Therapy Assistant (COTA®) exams are constructed to
measure entry-level competence of candidates who have met eligibility requirements for certification of the
respective credential.
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Exam Development
The OTR and COTA exams are constructed based on the results of practice analyses. The studies identify
the domains, tasks, and knowledge required for occupational therapy practice relative to the respective
credential. The ultimate goal of a practice analysis is to ensure that there is a representative linkage of exam
content to current practice. The periodic performance of practice analyses assists NBCOT with evaluating
the validity of the test specifications that guide content distribution of the credentialing exams.
Exam Administration
A standard NBCOT certification examination is a four-hour, computer-based exam taken in person at a test
center. The test center’s standard testing environment provides a quiet, limited/reduced distraction test
space with continual monitoring throughout the exam. For details on the test center environment, and exam
features and functionality in the computer-based testing environment view the What to Expect at the Test
Center video and the online exam tutorial(s).
Pearson VUE is NBCOT’s exclusive test administration partner. The OTR and COTA certification exams will
be administered at Pearson VUE’s highly secure network of fully owned and operated Pearson Professional
Centers (PPCs).
Pearson VUE is a global leader in computer-based certification and licensure testing and has extensive
experience supporting the health care credentialing sector, having delivered exams on behalf of over 120
health care certification programs worldwide across a range of dierent professions. For more information,
visit www.pearsonvue.com.
NBCOT Candidate/Certificant Code
of Conduct
Preamble
The National Board for Certification in Occupational Therapy, Inc. (“NBCOT,” formerly known as “AOTCB”) is
a professional organization that supports and promotes occupational therapy practitioner certification. This
Candidate/Certificant Code of Conduct enables NBCOT to define and clarify the standards of personal and
professional conduct required for eligibility for both initial and continued certification, i.e., OCCUPATIONAL
THERAPIST REGISTERED OTR® (OTR) henceforth OTR, and CERTIFIED OCCUPATIONAL THERAPY ASSISTANT
COTA® (COTA) henceforth COTA. Where the term “certificant” is used, the term “applicant or candidate” is
included in its scope.
It is vital that NBCOT certificants conduct their work in a professional manner to earn and maintain the
confidence and respect of recipients of occupational therapy, colleagues, employers, students, and the
public.
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As certified professionals in the field of occupational therapy, NBCOT certificants will at all times act with
integrity; adhere to high standards for personal and professional conduct; accept responsibility for their
actions, both personally and professionally; continually seek to enhance their professional capabilities;
practice in a competent, fair, honest, equitable, and just manner; abide by all federal, state, and local
laws and regulations; and encourage others to act in a professional manner consistent with the practice
standards and responsibilities set forth below.
Principle 1
Certificants shall provide accurate, truthful, and timely representations to NBCOT, including, but not limited
to:
• The submission of information on the exam application, certification renewal applications,
or the renewal audit form;
• Answers to character review questions and, once certified, the disclosure of any criminal,
legal, or other disciplinary matters within 60 days of any such matter;
• The submission of information requested by NBCOT for alleged violations of NBCOT’s
policies, requirements, and standards. Certificants shall cooperate with NBCOT concerning
investigations and requests for relevant information; and
• The submission of information regarding her/his/their credential(s), professional license(s),
and/or education.
Principle 2
Certificants shall abide by all exam-related security policies including, but not limited to, those involving
copying or removing exam content and accessing prohibited devices or materials during their exam.
Principle 3
Certificants shall be accurate, truthful, and complete in any and all communications, direct or indirect, with
any client, employer, regulatory agency, or other parties as they relate to their professional work, education,
professional credentials, research and contributions to the field of occupational therapy.
Principle 4
Certificants shall comply with state and/or federal laws, regulations, and statutes governing the practice of
occupational therapy.
Principle 5
Certificants shall not have been convicted of a serious crime.
Principle 6
Certificants shall not engage in behavior or conduct, lawful or otherwise that causes them to be, or
reasonably perceived to be, a threat or potential threat to the health, well-being, or safety of recipients or
potential recipients of occupational therapy services.
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Principle 7
Certificants shall not engage in the practice of occupational therapy while one’s ability to practice is
impaired due to chemical (i.e., legal and/or illegal) drug or alcohol abuse.
Principle 8
Certificants shall not electronically post personal health information or anything, including photos, that
may reveal a patient’s/client’s identity or personal or therapeutic relationship, without the patient’s/
client’s written consent. (All statements, regardless of intent, about a patient/client can potentially contain
suicient information for a member of a community to recognize the patient/client thus, violating the state
and/or federal law (i.e. Health Insurance Portability and Accountability Act (HIPAA)).
Principle 9
Certificants shall not misuse NBCOT’s intellectual property, certification marks, logos, or other copyrighted
materials. This includes all NBCOT exam preparation tools, website or exam content. Disclosure of practice
test questions or examination material content, including examination questions, is strictly prohibited.
Revised February 2003
Revised June 2006
Revised October 2008
Revised January 2010
Revised November 2011
Revised October 2013
Revised February 2014
Revised March 2014
Revised October 2016
Revised June 2018
Revised July 2020
Revised March 2021
Revised July 2022
Exam Certification Eligibility
Requirements
Eligibility Requirements
Candidates must meet the following eligibility requirements to sit for the NBCOT certification exam:
• Obtain an occupational therapy degree that meets current entry-level degree requirements:
▷ OTR candidates must graduate with an entry-level occupational therapy degree from an ACOTE®-
accredited occupational therapy (OT) program
▷ COTA candidates must graduate with an entry-level occupational therapy degree from an ACOTE®-
accredited occupational therapy assistant (OTA) program
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▷ Internationally educated candidates: If you did not earn your entry-level master’s or doctoral
degree in occupational therapy from a U.S.-accredited college/university, you must apply through
the Occupational Therapist Eligibility Determination (OTED®) process. Please refer to the NBCOT
website for details.
• Agree to abide by the NBCOT Practice Standards and Code of Conduct
• Receive character review approval
Note: NBCOT may change or update exam eligibility requirements to meet industry standards. Changes in
eligibility requirements will be communicated well in advance of taking eect.
Should eligibility requirements change in the future and a candidate has not attained certification, the
candidate has three (3) years from their date of graduation reflected on the final transcript to take the exam
under the prior eligibility requirements. Aer three years from the date of graduation, a candidate must
meet current eligibility requirements to sit for the exam.
Eligibility Appeal Process
If a candidate is determined ineligible to take the certification exam, the candidate has the right to appeal
that decision in writing to the NBCOT Board of Directors. Within 21 days from the date of the ineligibility
notification, the candidate may submit a letter of appeal that MUST outline the grounds for the appeal,
including reason(s) why the application should be recognized and accepted by NBCOT. All letters should be
sent via traceable mail (i.e., certified, UPS, Fed Ex) to:
NBCOT, Inc. Attn.: President and Chief Executive Oicer
One Bank Street, Suite 300
Gaithersburg, MD 20878
In the case of an ineligibility due to a violation of the NBCOT Code of Conduct, please refer to the Procedures
for the Enforcement of the Candidate/Certificant Code of Conduct.
Application Process
Submitting the Application
Candidates apply for the certification exam online at nbcot.org.
The exam application must be completed by the candidate. Applications completed and/or submitted by a
third party (e.g., family members, recruiters, program directors, fieldwork coordinators, professors) are
not valid and the candidate will be deemed ineligible for three (3) months with all application fees forfeited.
Once submitted, the exam application is valid for 90 days.
All components of the application must be fulfilled and approved (e.g., academic verification
documentation, background check, testing accommodations if applicable) for an application to be
processed and an Authorization to Test letter (ATT) generated (refer to page 18). ATT letters are not
processed and cannot be reissued on expired applications. Once an application is expired, candidates must
submit a new exam application and pay all applicable fees.
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Online Application for First-Time Exam Candidates:
1. Read the Certification Exam Handbook in full BEFORE applying for the exam. The handbook includes
important information and instructions and is a required step in the application process.
2. Create a MyNBCOT account.
▷ If you already have a MyNBCOT account, log in using your unique email address and password.
*Note, an online account should only be created once. A $35 USD fee will be assessed if a duplicate
account is created. If you have forgotten your password, click on the “Forget Your Password?” link on
the MyNBCOT login page. If you are unsure if you have an account, or if your SSN will not allow you to
create an account, you may already have one. Contact NBCOT customer service at info@nbcot.org or
call 301-990-7979 during business hours (9 a.m. to 5 p.m. eastern time) for assistance.
▷ For new users, visit nbcot.org, click Log In, and select Create Account.
▶ Select the I have never been OTR or COTA certified* button.
*Note, an online account should only be created once. A $35 USD fee will be assessed if a duplicate
account is created.
▶ Complete your account information and click Submit.
▶ You will receive an email from NBCOT asking you to validate your email address in order to
activate your MyNBCOT account (check your spam/junk folder for the email confirmation).
3. Apply for the exam.
▶ Plan ahead! Submit your application when you plan to test within 90 days of the submission
date.
▶ If you are unable to complete the exam application in its entirety in one session, you may click
Save and Quit and complete the application later. As long as the application remains in the
“New” status, you may make changes to the exam application.
▶ Do not use the back browser to review the application; it may cause the application to fail. Use
the Continue and/or Back buttons within the application.
▷ Log into your MyNBCOT Account
New and repeat applicants: Once logged into your MyNBCOT account, click on the Start My OTR/
COTA Exam Application button.
If you previously took and passed the COTA exam and you are now eligible for the OTR exam, log
into your existing MyNBCOT account. Go to Student Dashboard in the drop-down menu under your
name. You will need to add an OT degree to your Profile before you can complete your OTR exam
application.
▷ Review and complete your Profile.
Review and update your contact information. The email and address provided will be used to
communicate important information.
IMPORTANT: You must provide a valid street address, NOT a P.O. Box, in order for the background
check to be verified.
Click Continue.
▷ Review and confirm your academic information.
Click Continue.
▷ Honestly answer character questions and upload probation documentation, if applicable. (See
“Character Review” on page 13 for details.)
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Click Continue.
▷ Select Yes or No for Testing Accommodations.
If Yes, refer to the Testing Accommodations section of the NBCOT website and submit all the
required information and documentation.
Note: Candidates requesting TA must upload at least one supporting document to continue.
Candidates may upload additional documentation throughout the application approval process.
Click Continue.
▷ Select your Services by clicking the appropriate Add to Cart button.
Note: Candidates may request one free Score Transfer and one free Eligibility Confirmation Notice per
application. The discount is reflected upon checkout.
There is a $35 USD fee for each additional notice or transfer requested.
The one free Score Transfer and/or Eligibility Confirmation Notice request is only available prior to
application payment. Aer the application payment is submitted, requests are $35 USD each.
Click Continue.
▷ Select if you want your Performance Feedback Report sent to your program director under the
Program Preferences section.
Note: You are not obligated to release this report.
Click Continue.
▷ Read the Attestation statement and check the box.
Click Continue.
▷ Review your cart and confirm your order is correct.
If the order is correct, click Proceed to Checkout.
If edits are required, click Return to your Cart. Click Remove. Return to your Dashboard and click
Finish My Exam Application. Make desired changes.
▷ Complete shipping information (if applicable).
Click Continue to Payment.
▷ Complete payment information.
Click Continue to Review Order.
▷ Review your order.
If correct, check the box to agree to the Terms and Conditions and Refund Policy.
If edits are required, click Remove. Return to your Dashboard, click Finish My Exam Application, and
make desired changes.
Click Submit Order.
4. Once the exam application is submitted:
▷ You may make the following revisions to your application when in “New” status:
• Changing testing accommodations requests
• Changing contact information
• Changing name
▷ You may update your mailing address, email, phone, and password at any time by logging into
your account and selecting Edit Profile.
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▷ If corrections are needed aer the application has been moved from “New” status to “Review in
Progress” or “Processed” (with the exception of address, email, or phone updates), contact info@
nbcot.org or 301-990-7979 for assistance.
▷ Candidates can check on the status of their application by logging in to their MyNBCOT account.
Character Review
Exam applicants are required to answer the following questions as part of the NBCOT character review:
1. a. Have you ever been convicted of a felony? (NOTE: Applicants must answer airmatively even if
convictions have been pardoned, expunged, released, or sealed.)
b. Do you currently have a felony charge or charges against you?
2. a. Have you ever surrendered any professional license, registration, or certification or had one
denied, revoked, suspended, or subject to probationary conditions by a regulatory authority or
certification board, including NBCOT?
b. Do you currently have a professional license, registration, or certification under review for
possible disciplinary action?
3. a. Have you ever been found by any court, administrative, or disciplinary proceeding to have
committed negligence, malpractice, recklessness, or willful or intentional misconduct which
resulted in harm to another?
b. Do you currently have a charge(s) of negligence, malpractice, recklessness, or willful or
intentional misconduct that resulted in harm to another against you?
4. a. Have you ever been suspended and/or expelled from a college or university?
b. Are you currently under active investigation that could lead to being suspended and/or expelled
from a college or university?
The NBCOT character review also consists of a background check. It is important to note that failure to
answer the character questions honestly is a violation of Principle 1 of the NBCOT Code of Conduct.
Applicants who answer “Yes” to any of the character questions on the exam application MUST submit the
following required documentation in their exam application:
• A detailed, written explanation regarding the incident(s). Please describe your involvement and
behavior in the incident(s), including how your actions were discovered.
• If you have been on parole or probation at any point within the last seven (7) years, you must include
documentation confirming your compliance with or completion of all terms and conditions imposed
by the court. This can be a letter from your probation oicer, or other oicial court documentation.
• Please note that a Yes answer does not automatically deny your application, nor do certain behaviors
automatically result in specific determinations. Each case is reviewed individually for a determination.
NBCOT may request additional information as needed or when warranted by the results of the background
check.
All information MUST be submitted to and reviewed by NBCOT before the exam application may be
approved. Aer NBCOT has completed its review, the individual is notified in writing regarding whether they
will be eligible to sit for the NBCOT exam, provided that all other eligibility requirements are met.
If an exam candidate answered “Yes” to a character question and was cleared for the exam, or received
a favorable Early Determination Review prior to applying, the candidate MUST answer the appropriate
character question(s) on the exam application airmatively when applying or reapplying for the exam.
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If the airmative response is in reference to the same issue that NBCOT previously reviewed, and no
further incidents have occurred, the candidate MUST send written confirmation of this to professional.
conduct@nbcot.org aer reapplying. The candidate will not need to resubmit any previously submitted
documentation.
If there have been additional incidents or further action resulting in an additional airmative answer to
one or more of the character questions, the candidate MUST answer the appropriate character question(s)
airmatively and submit information regarding the new incident to NBCOT for review. If the candidate fails
to inform NBCOT, disciplinary action may result. Notifications should be sent to professional.conduct@
nbcot.org.
If an exam candidate received a favorable review from the Early Determination Review process, the
candidate will be required to undergo another background check as part of their exam application.
If a candidate answers “Yes” to a character question in error, the answer can be changed provided that the
application is still in “New” status. If the application has moved beyond the “New” status, the candidate
should send an email noting the error to professional.conduct@nbcot.org.
Testing Accommodations
In compliance with the Americans with Disabilities Act (ADA), NBCOT provides reasonable and appropriate
testing accommodations (TAs) for exam candidates with disabilities who are otherwise eligible to take the
OTR or COTA certification examination.
For details on requesting testing accommodations and to view a list of personal items that do not require a
request for TAs, refer to the Testing Accommodations section of the NBCOT website. Direct specific questions
to accommodations@nbcot.org.
Please note, a request for testing accommodations may increase the amount of time it takes to process an
exam application.
NBCOT accepts either an oicial, final college or university transcript or a Degree Verification Form for the
purpose of determining eligibility for testing.
NBCOT requires an oicial, final college or university transcript for OTR or COTA certification to be granted.
Transcript Requirements
Candidates MUST arrange to submit to NBCOT an oicial final college or university transcript that includes
all information listed below.
Candidates may request the oicial final transcript aer an NBCOT account is created or aer submitting
the exam application and payment. Transcripts sent before an NBCOT account has been created will be
destroyed aer 30 days from the date of receipt.
Internationally educated candidates approved through the Occupational Therapist Eligibility Determination
(OTED) process are not required to submit another transcript.
The oicial final transcript MUST include ALL of the following:
☑ Candidate’s full name
☑ Candidate’s social security number OR student identification number
☑ Name of the institution awarding the occupational therapy degree
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☑ Listing of all courses completed and required for the ACOTE-accredited entry-level degree
☑ Identification of the major: either “occupational therapy” or “occupational therapy assistant”
☑ Title of the entry-level degree awarded in occupational therapy
☑ The date on which the degree was awarded/conferred. The degree must have been awarded.
Transcripts with a graduation date that is aer the transcript issue date will not be accepted.
☑ The registrar’s oicial seal, stamp, or signature
If the transcript does not contain all of the above information, NBCOT will notify the candidate via email
that the application cannot be processed until the information is received.
The following will not be accepted: a transcript marked “unoicial copy,” a photocopy, or a letter from the
school.
The application process is not complete until this documentation is on file with NBCOT. Candidates may log
in to their MyNBCOT account to check on whether NBCOT has received a final transcript.
Transcripts are reviewed in the order they are received. This process can take up to 10 business days and
may take longer during busy times.
SENDING YOUR OFFICIAL FINAL TRANSCRIPT
Your oicial final transcript must be sent one of the following ways:
• A secure document transcript service or clearinghouse. NBCOT will only accept transcripts
electronically that are transferred using a secure and verifiable transcript service or clearinghouse.
The documents should be sent to transcripts@nbcot.org. NBCOT does NOT accept transcripts emailed
directly from your institution’s registrar’s oice.
• Directly from your institution’s registrar’s oice. A mailed transcript from the registrar’s oice must
be placed in an envelope that either has a return address for the registrar’s oice OR is marked with a
registrar’s stamp, the registrar’s initials, or “Transcripts Enclosed” on the back flap.
Transcripts should be mailed via USPS only to:
NBCOT, Inc.
One Bank Street, Suite 300
Gaithersburg, MD 20878
DEGREE VERIFICATION POLICY
Students enrolled in an ACOTE-accredited occupational therapy education program and scheduled to
graduate with an associate, baccalaureate, entry-level master’s, or entry-level doctoral degree may request
that their university or college registrar submit a Degree Verification Form (DVF), within six (6) months of
their anticipated graduation date. Students must have successfully completed all degree and graduation
requirements, including occupational therapy education, Level I and Level II Fieldwork, and, for OTD
students, the doctoral capstone experience and project. The form may only be used within the same
calendar year as the student’s anticipated graduation date.
Each academic program is responsible for determining if the use of the DVF is appropriate for their students.
Please refer to the full Degree Verification Policy.
Candidates who meet all requirements may log in to their MyNBCOT account and submit a DVF
electronically for approval by their program director. The program director will then access pending
DVF requests in their NBCOT Program Director Portal. Aer the program director reviews and approves
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a student’s DVF, the program director will provide either a physical or electronic copy of the DVF to the
university/college registrar. The registrar or registrar-authorized individual will complete the DVF and submit
it to NBCOT.
DVF candidates will not have their pass/fail status released until NBCOT has received and approved an
oicial final transcript that includes all information outlined in the Transcript Requirements section.
Reporting Services
NBCOT oers the following reporting services to candidates applying for the certification exam:
• Score Transfer
• Eligibility Confirmation Notice (State and Employer)
The candidate is responsible for contacting the occupational therapy state regulatory board or employer
to determine which service(s) is required. For example, some states may require a Score Transfer for every
exam attempt. Candidates may log in to their MyNBCOT online exam application to add services at any time,
under the “Services” section of the application.
SCORE TRANSFER
Candidates may request that NBCOT send an electronic Score Transfer to a state regulatory board. A state
regulatory board will NOT automatically receive a score unless a Score Transfer service has been ordered. All
states accept scores except Hawaii.
Candidates may request one free Score Transfer with their exam application. There is a $35 USD fee for each
additional Score Transfer request, and for any Score Transfer request made aer the exam application is
submitted. A Score Transfer to a state may not be removed or substituted for a Score Transfer to another
state.
Score Transfers can be requested when applying for the exam, aer the exam application has been
submitted, or aer the exam has been taken. If a candidate orders the service prior to sitting for the exam,
the score will be sent electronically within 2-3 business days of the exam being scored. If the candidate
orders the service aer taking the exam, the score will be sent electronically within 2-3 business days of
receipt of the request. Candidates can check on the status of their Score Transfer request in their MyNBCOT
account. Click on Application and expand the Services section from the Student Dashboard. Ordered items
cannot be canceled or refunded aer the request has been submitted.
If a candidate requests a Score Transfer and the SSN provided to NBCOT does not match the SSN provided to
the state regulatory board, the candidate’s results will not be accessible by the state. In this case, candidates
must order a new Score Transfer and pay all applicable fees.
Completion of the NBCOT Certification Exam Application is not the same as applying for state
licensure. Sending a score transfer to a state regulatory board does not initiate the process
to obtain a license or permit to work in that state. Certification by NBCOT is independent,
dierent, and separate from any state or jurisdiction’s law/licensure. Almost all jurisdictions,
including the District of Columbia and Puerto Rico, have some form of regulation of
occupational therapists and occupational therapy assistants. Before a candidate begins
practicing in any state or comparable jurisdiction, it is essential that all requirements of that
jurisdiction are met. To practice without a license or permit is against the law.
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ELIGIBILITY CONFIRMATION NOTICE
This service confirms a candidate has applied for and been deemed eligible to take the NBCOT certification
exam. Candidates who want an Eligibility Confirmation Notice sent to a state regulatory board, employer,
or themselves can select this service when applying for the exam. Aer the exam application has been
approved, notices requested to state regulatory boards are sent via secure electronic transfer within 2–3
business days. Notices requested to companies or candidates via email are also sent within 2–3 business
days. Those requested by mail are sent via USPS within 2 weeks.
Candidates may request one free confirmation notice (state or employer) with the exam application. There
is a $35 USD fee for each additional notice requested, and for any confirmation notice requests made
aer the exam application is submitted. Candidates may check the status of their confirmation notice in
their MyNBCOT account. Ordered items cannot be canceled or refunded aer the request has been
submitted.
The notice includes:
1. Confirmation that the candidate’s exam application and fees have been processed
2. Confirmation that NBCOT has received and accepted the candidate’s oicial final transcript or
Degree Verification Form (DVF)
3. Confirmation that the candidate is approved to schedule their test date with Pearson VUE
4. The candidate’s exam history: a listing of the candidate’s exam dates from 1997-present
The following states do NOT accept Eligibility Confirmation Notices: Alabama, Arizona,
Colorado, Hawaii, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, New Hampshire,
North Carolina, South Carolina, Washington, and Wisconsin.
Program Preferences
Candidates may choose to share their Performance Feedback Report with their program director. This is the
same report that will be posted in the candidate’s MyNBCOT account aer the exam score is released. The
report will include the exam results and will only be sent if the candidate opts in and is unsuccessful on the
exam. Candidates are not obligated to release this report.
Candidates may make this request when applying for the exam, aer the exam application has been
submitted through the Exam Application Summary, or aer the exam has been taken through the Exam
Application History. If a candidate opts in to release this report before their score is released, the report will
be posted electronically to their program director’s portal immediately upon score release. If a candidate
makes this request aer their score is released, the report will be posted electronically to their program
director’s portal within 1-3 business days of receipt of the request. Once the report has been posted to the
program director portal, it cannot be removed.
Fees
Payment for exam applications, and any additional services such as Score Transfers, and Eligibility
Confirmation Notices must be made by credit card (Master Card, Visa, Discover, or American Express). The
NBCOT exam application fee is due at the time of submission. No o-line payments are accepted. An exam
application cannot be processed until the exam application fee is paid in full.
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Remember, you may request one free Score Transfer AND one free Eligibility Confirmation Notice ONLY if
ordered at the time your exam application is submitted. If selected, the service fees are discounted in your
cart when checking out. If multiple services are ordered with your exam application, each additional service
is $35 USD. AFTER the exam application is submitted, Score Transfer or confirmation notice requests are $35
USD each.
Approved Applications
Authorization to Test (ATT) Letter
The ATT letter authorizes candidates to schedule and take the certification exam. It will include details on
how to schedule the exam directly with Pearson VUE, and how to reschedule or cancel an exam, if necessary.
If a candidate is approved for testing accommodations, the ATT letter will include the words “Testing
Accommodations” on the top of the letter.
Aer NBCOT approves a candidate’s exam application, they will receive an ATT letter by email (and in their
MyNBCOT account) within three (3) business days.
Note: some email providers filter NBCOT email notifications to spam/junk folders. Please check your spam/
junk folder and add NBCOT to your preferred senders list.
The ATT letter is active for 90 days. Candidates must test during the date parameters outlined in the ATT
letter.
If needed, candidates may request an ATT letter reissue by clicking the I Need to Reissue My ATT Letter
button in the candidate’s MyNBCOT account.
• A request to reissue an ATT letter for an additional 90 days of eligibility must occur while the exam
application has not expired. Please check the exam application expiration date. Click on the My
Exam App button located on the MyNBCOT dashboard and expand the summary section to view the
expiration date.
• To successfully reissue an ATT letter, the candidate must cancel any existing exam appointment(s).
Once a candidate reissues an ATT letter, the prior letter is voided. The candidate may no longer test on
the prior ATT letter.
• If an exam application is expired, the ATT letter can no longer be reissued; a new exam application and
full application fee must be submitted.
Your application must have not expired to reissue your ATT letter.
Reasons ATT letters are reissued include:
• A name change
• Current ATT letter has expired
• Intending to schedule exam beyond the current ATT letter expiration date
• Cancellation of exam and unable to reschedule within current ATT letter dates
• Arrival at the test center more than 15 minutes aer scheduled exam start time and unable to test*
• Arrival at the test center without the proper ID and unable to test*
• Attempting to cancel or reschedule an exam appointment less than 48 hours prior to scheduled date*
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• Failure to appear for a scheduled exam appointment (no show)*
*There is a $115 USD fee for ATT reissue in this circumstance.
It is the candidate’s responsibility to check their email and MyNBCOT account to see whether the ATT letter
has been sent to them. Candidates can view and print a copy of their current ATT letter from their MyNBCOT
account.
Scheduling the Certification Exam
Aer the ATT letter is received, candidates schedule their testing appointment directly with Pearson VUE.
Candidates SHOULD NOT contact Pearson VUE until they have received the ATT letter.
Candidates planning to receive their exam result on a specific scoring date MUST take the exam a
minimum of three days prior to the desired score release date. The scoring schedule can be accessed on the
NBCOT website. NBCOT aims to make exam results available on the scheduled score release date; however,
there may be unforeseen circumstances when this is not possible. In these cases, scores will be posted as
soon as possible.
Scheduling an Appointment Date
Pearson VUE is NBCOT’s exclusive test administration partner. Candidates can review test center locations,
important information, and log in to schedule on the NBCOT/Pearson VUE homepage.
Candidates can link to their personalized Pearson VUE dashboard by logging in to their MyNBCOT account
and clicking the Schedule My Appointment button.
Exams must be scheduled a minimum of one day before the appointment. Same day appointments are not
available.
Candidates approved with testing accommodations should follow the scheduling instructions in their ATT
letter with Testing Accommodations and the Testing Accommodations Approval Notice.
REGISTRATION
When scheduling, candidates will be presented with a biometric-enabled check-in notice. This notice will
explain the collection and usage of biometric information. Please refer to “Exam Day: Questions & Answers”
on page 26 for more information on biometric-enabled check-in.
NAME AND ADDRESS CONSIDERATIONS AND CHANGES
The name (first and last) provided on the exam application is the name printed on the Authorization to Test
(ATT) letter.
Candidates are required to present two forms of identification during check-in at the test center. Both forms
of ID MUST match the first and last name indicated on the ATT letter. If the first and last name on the IDs do
not match the ATT letter, the candidate will not be admitted to test. In this case, a new ATT letter is required
to schedule a new appointment date.
For more information about acceptable forms of ID, see “Acceptable forms of primary identification include”
on page 26.
The address on the ATT letter and the identification do not need to match. Please ensure the address in your
MyNBCOT account is correct.
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Name Change
Name changes cannot be made at the test center.
• Candidates who have had a legal name change MUST notify NBCOT of their new name.
• To request a name change: Log into your MyNBCOT account and select Name Change in the drop-down
menu under your name.
Please read the following information as you complete the name change:
• If you require a name change and have been issued an ATT letter, please do not schedule an exam
appointment. If you have scheduled an exam appointment, you must cancel the appointment
with Pearson VUE. NBCOT cannot complete a name change when you have a scheduled exam
appointment.
• Candidates retaking the exam and who have had a legal name change since the last exam
administration should complete an online name change request prior to reapplying for the exam.
• Remember, if you request a name change and receive a new ATT letter, your required IDs must
match your new name for security check-in at the test center.
• NBCOT does not charge a fee for candidate name changes.
• NBCOT requires legal documentation to process a name change. Please upload copies of your oicial
documents reflecting the name change and select Add to Cart. A scanned copy or a picture taken with a
smartphone are both acceptable.
• Accepted government-issued ID documents for name change purposes include: driver’s license, state-
issued ID, military ID, passport, or signed social security card.
• The following documents are not accepted as proof of a name change: student ID, marriage certificate,
or divorce decree.
• You must go to your cart and checkout to submit the name change order.
• Candidates are notified by email when the name is updated or contacted if additional documentation
is required. Please allow up to three (3) business days for processing.
• Candidates can request a new ATT letter with updated name aer being notified of a completed name
change (if applicable).
Address Change
A candidate can update their address online at any time by logging in to their MyNBCOT account and
selecting Edit Profile in the drop-down menu under their name.
REFUND POLICY
Refund for Personal and/or Medical Emergencies
Candidates experiencing a personal or medical emergency who are unable to test when their application
and eligibility are active (unexpired) should notify NBCOT at credentialingservic[email protected]g. NBCOT
reserves the right to request documentation verifying the event/circumstances related to the request. These
inquiries will be considered on a case-by-case basis.
NBCOT Exam Products and Services Refund Policy
There are no refunds or exchanges for products or services except in cases of duplicate payments, over-
payments, or exam application withdrawals. There is a $40 USD processing fee for all refunds.
Any refund granted will be refunded by the same payment method and to the same party as the original
transaction.
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APPLICATION WITHDRAWAL
Candidates who withdraw their exam application may receive a partial refund. Candidates MUST completely
withdraw their exam application within three months of the Created On date of the application (review
the summary section of your application for the Created On date) by submitting the request, with a brief
explanation, via email to inf[email protected]g. Approved refunds will be processed within 30 days of NBCOT
approval. Candidates who withdraw their exam application can reapply for the exam three months from the
date of their withdrawal request. In the case of a sanction of ineligibility for certification, the sanction terms
will prevail.
CANCELLATION, RESCHEDULE, LATE ARRIVAL, NO SHOW POLICY
The following applies to exam candidates who cancel, reschedule, arrive late, or do not appear for
their scheduled exam.
Candidates testing with Pearson VUE can reschedule or cancel up to 48 hours before their exam
appointment date. Candidates reschedule or cancel by clicking the Manage My Appointment button on their
MyNBCOT dashboard.
Candidates who attempt to cancel or reschedule less than 48 hours before their appointment date or who
do not appear for their appointment must request a new ATT letter aer their appointment date passes.
There is a $115 USD fee to reissue your ATT letter in these circumstances.
If you need to cancel 48 hours or less from your exam appointment due to an emergency, please contact
NBCOT at credentialingservices@nbcot.org or NBCOT customer service at 301-990-7979.
A request to reissue an ATT letter for an additional 90 days MUST occur while the exam
application is still active (unexpired).
Preparing for the Exam
Exam
Exam content is derived from the results of practice analyses and developed to measure the knowledge
required for practicing as an entry-level OTR or COTA.
The following presents the domain areas and proportion of test items established for the OTR and COTA
blueprints of the certification examination content outlines from January 2024.
OTR DOMAIN DESCRIPTIONS
Domain 01: Evaluation and Assessment — 23%
Acquire information regarding factors that influence occupational performance on an ongoing basis
throughout the occupational therapy process.
Domain 02: Analysis, Interpretation, and Planning — 23%
Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan
throughout the occupational therapy process.
Domain 03: Select and Manage Interventions — 38%
Select and implement interventions to promote healing and enhance engagement in occupation-based
activities.
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Domain 04: Competency and Practice Management — 16%
Manage professional activities of self and relevant others as guided by evidence, regulatory compliance, and
standards of practice to promote quality care.
COTA DOMAIN DESCRIPTIONS
Domain 01: Collaborate and Gather Information — 27%
Under the supervision of the OTR, acquire information on an ongoing basis regarding factors that influence
occupational performance.
Domain 02: Select and Implement Interventions — 55%
Implement interventions, under the supervision of the OTR, in accordance with the intervention plan
and level of service competence to support client participation in areas of occupation throughout the
occupational therapy process.
Domain 03: Uphold Professional Standards and Responsibilities — 18%
Uphold professional standards and responsibilities by achieving service competence and applying
evidence-based interventions to promote quality in practice.
VALIDATED DOMAIN, TASK, AND KNOWLEDGE STATEMENTS
FOR THE EXAM
Within each domain area of the exam, there are a number of associated task and knowledge statements.
All items on the NBCOT exams are classified according to these domain, task, and knowledge statements.
The 2022 OTR Examination Content Outline and 2022 COTA Examination Content Outline for the exams are
available online. Candidates should refer to our website for the most up-to-date information regarding the
content of the exam.
FORMAT OF TEST ITEMS ON THE EXAMS
NBCOT exams contain the following:
• OTR: 180 items comprising a mix of three- and four-option single-response multiple-choice items and
six-option multi-select scenario sets
• COTA: 190 items comprising three- and four-option single-response multiple-choice items and six-
option multi-select items
Three- and Four-Option Single-Response Multiple-Choice Items
Each single-response multiple-choice item starts with a stem or premise written in the form of a question.
Either three or four possible response options are listed beneath the stem. From the options listed, there is
only ONE correct response; the other options are incorrect responses.
Candidates need to decide the ONE best response based on the information presented in the stem.
Highlight and strike out features are available on the computer to assist the candidate during their decision-
making process.
Candidates will use the computer mouse to click the button to the le of ONE response option to indicate
their selection. Candidates can change selected responses by clicking the button to the le of a dierent
response option. Candidates receive credit for selecting the correct response option. Points are not
deducted for selecting incorrect response options.
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During which task would a stereognosis deficit secondary to a CVA be MOST EVIDENT?
A. Getting coins from a pocket
B. Pouring water into a cup
C. Putting on a pair of socks
During which task would a stereognosis deficit secondary to a CVA be MOST EVIDENT?
A. Getting coins from a pocket
B. Pouring water into a cup
C. Putting on a pair of socks
D. Opening a pill bottle
Six-Option Multi-Select Items (COTA Exam Only)
Each six-option multi-select item includes a question stem followed by six response options. Of the six
response options provided, there are THREE correct responses; the other three options are incorrect
responses. Highlight and strike out features are available on the computer to assist the candidate during
their decision-making process. Candidates receive credit for each correct response option selected. Points
are not deducted for selecting incorrect response options.
Of the six response options provided the candidate must select THREE responses.
Example: Six-Option Multi-Select Item
A client has right homonymous hemianopsia secondary to a CVA several months ago. Deficits in the client’s
right visual field interfere with the client’s ability to participate in IADL. One of the client’s goals is to
improve visual perceptual skills to be able to resume a hobby of cooking meals using recipes from a favorite
cookbook. Which adaptive strategies should the COTA teach the client to use in order to achieve this goal?
Select the three BEST responses. (First, second, and fourth options are correct.)
☑ Place boundary markers on the right side of the printed recipe.
☑ Mark o each step of the recipe instructions as it is completed.
☐ Use a fluorescent pen to highlight key words in the recipe instructions.
☑ Place a ruler under each line of print that is being read on the recipe.
☐ Scan the page to search for the first letter of each word in the recipe.
☐ Direct eye gaze towards the le margin of the recipe instruction page.
Multi-Select Scenario Sets (OTR Exam Only)
Each multi-select scenario set consists of an opening scene that contains general background information
about a practice-related situation, followed by four related items.
Each item is followed by six response options, three of which are correct and three of which are incorrect.
Candidates must select the three best choices.
For all exam items, candidates receive credit for selecting the correct response options. There are no
deductions for selecting incorrect response options.
We oer access to sample scenario sets so candidates can familiarize themselves with the structure of the
item type. These sample items do not replicate the candidate experience on exam day.
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Please view the exam tutorial for more information.
Sample Scenario Set 1
Sample Scenario Set 2
HIGHLIGHT, STRIKE OUT, AND OTHER FEATURES
During the exam, candidates will be able to highlight text in the passage area that they feel is important
to refer back to as they progress through the exam. A strike out feature is also available to help candidates
visually eliminate possible options from consideration. Candidates have the option to modify the color
scheme by changing the background and text colors of the exam at any time. Candidates can also adjust the
screen brightness and change the size of the content by zooming in or out on the screen. For details on these
features, as well as additional functionality of the exam in the computer-based testing environment, view
the online exam tutorial(s).
Study Tools: NBCOT Aspire®
Designed using the exam content outline on which the certification exam is based, Aspire study tools are
optional resources to include in your personalized study plan in whatever way works best for you.
NBCOT EXAM STUDYPACK®
Mobile-friendly, dynamic, and interactive, the StudyPack is a comprehensive collection of tools that includes
My Study Plan, an electronic study guide, flashcards, mini tests, Knowledge Match games, practice tests, a
full practice exam, and much more.
Available for $85 USD
Access to the StudyPack remains until a passing score is earned on the certification exam.
Candidates who purchase the StudyPack and have an unsuccessful attempt on the exam will
have the StudyPack refreshed for no additional cost.
NBCOT STUDY GUIDE
Learn all about the exam, test-taking strategies, tips to develop a personalized study plan, and so much
more. Includes practice questions with answers, rationales, and references.
Available for $60 USD (hard copy) or $40 USD (electronic)
The study guide is available in the NBCOT Exam StudyPack as an electronic version. Please
note that you cannot print the online (electronic) version.
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NBCOT FLASHCARDS
Flashcards are grouped by the domains of the exam content outline and can be filtered by topic areas to
help organize your studying!
Available for $15 USD
Flashcards are available in the NBCOT Exam StudyPack and include even more cards to
prepare for the exam.
KNOWLEDGE MATCH GAME
Interactive and challenging matching games to test your OT knowledge. Choose a topic and get ready to
play!
Available for $9 USD
The Knowledge Match Game is available in the NBCOT Exam StudyPack.
NBCOT PRACTICE TESTS
Based on the exam outline and created to mirror the format and flow of the certification exam, practice tests
provide an opportunity to build confidence and use test-taking strategies.
Some practice tests are available in the NBCOT Exam StudyPack and some are available for
individual purchase.
NBCOT study tools are designed to assist candidates with their exam preparation. NBCOT does
not guarantee enhanced performance on the NBCOT certification exams for those using these
products.
NBCOT’s Aspire study tools are copyrighted and protected by the United States Copyright
Oice. Copying, sharing, or posting NBCOT’s materials is illegal and violates the Code of
Conduct. Individuals in violation of the code are subject to disciplinary action and could
jeopardize their ability to sit for the certification examination and/or be certified to obtain a
license to practice.
NBCOT does not require, approve, or endorse any preparatory courses or study materials
relating to the NBCOT certification exams. Individuals who participate in the development of
NBCOT Aspire study tools have no access to confidential examination content.
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Exam Day: Questions & Answers
WHAT ARE THE REQUIREMENTS FOR ADMISSION TO THE TEST
CENTER
?
Appointment Arrival Time
You MUST arrive 30 minutes prior to your scheduled appointment.
ID Information
You must present two forms of ID: one primary and one secondary, or two primary. Refer to
Acceptable forms of identification lists below.
The first and last name on both IDs MUST match the first and last name on the ATT letter. The middle
name/initial is not required for ID purposes.
The address on the ATT letter and the identification does not need to match. Please ensure the
address in the MyNBCOT account is correct.
All forms of ID MUST be original and MUST have a signature that matches the first and last name of
the ATT letter.
Valid, unexpired government-issued photo ID with legal name and legible signature.
• Driver’s license requirements: Current issue date, legal name, signature, photograph
• Passport requirements: Current issue date, legal name, signature, photograph
• State-issued ID requirements: Current issue date, legal name, signature, photograph
• Permanent Resident/Green Card requirements: Current issue date, legal name, signature/barcode,
photograph
• Military ID requirements: Current issue date, legal name, signature/barcode, photograph
Unexpired ID from the secondary list must contain both printed name and legible signature.
• Current major credit card with expiration date (Visa, Master Card, American Express, or Discover)
• ATM card
• Employee ID card
• Student ID card
• Original social security card
• Any ID from primary ID list
Face masks are not required at the test center; however, individual test centers may be required to comply
with any local or government social distancing requirements, which are subject to change.
Candidates who choose to wear a face mask during testing will be asked to lower their mask as part of the
check-in/identity verification process.
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If you are sick/have been sick within the past two weeks, have recently traveled, or have recently been
exposed to someone who tested positive for COVID-19, we strongly urge that you stay home to help ensure
the safety of test center employees and other test-takers, and recommend that you reschedule your exam.
ARE BIOMETRICS COLLECTED AT THE TESTING CENTER?
Pearson VUE will take a digital candidate photo and collect a digital signature to match with the primary
ID. They also utilize palm-vein biometric screening, which is a non-invasive and highly accurate measure
of identity. You will place your palm on the scanner, which uses a near-infrared light source (similar to a
TV remote) to scan the veins in your palm. The information is converted to a digital template and used to
prevent anyone from testing under your identity. There is video surveillance in all candidate-accessible
areas of the testing center.
WHAT ITEMS ARE PROHIBITED WHILE TAKING THE EXAM?
Prohibited items include ANY electronic device (cell phones, personal digital assistants [PDAs], or any type
of camera device), any type of watch, any jewelry outside of wedding and engagement rings, weapons, or
any hard copy documentation. These items are not allowed in any area of the testing facility, including,
but not limited to, the lobby, bathroom, test administration check-in and/or waiting rooms, or the test
administration room. Purses, backpacks, totes, and other bags must remain in your locker and may not be
accessed at any time during the exam appointment.
Test center sta conducts inspections of all eyeglasses, jewelry, and other accessories. Candidates may be
asked to remove these items for inspection. Questionable items should not be brought into the test center.
Questionable items brought into the test center may need to be placed in your locker. To avoid delays at
check-in and upon return from breaks, candidates may wish to take the necessary steps to leave such items
at home or in their car.
If you are found accessing a cell phone, using an electronic device, in possession of any type of camera
device, or referencing exam-related material during any part of the test administration process, test center
sta will require you to step out of the test administration area. The sta member will inform you that you
have violated test center rules and a detailed report will be filed with NBCOT. You will be dismissed and the
exam terminated. Any type of camera device will be confiscated by Pearson VUE. Your future exam eligibility
status will be determined by NBCOT.
CAN I USE EARPLUGS?
Earplugs are available for all candidates testing at Pearson Professional Centers.
If a candidate wants to bring/use their own custom pair of earplugs, formal testing accommodations
approval is required. Earplugs must be stand-alone earplugs, with no wires, and are subject to visual
inspection at the test center.
Please refer to the NBCOT Testing Accommodations Handbook for further information.
THE TESTING ROOM?
• A light sweater or jacket may be worn in the testing room and may be taken on or o as needed. Heavier
jackets or coats are not allowed to be worn in the testing room.
• Once in the testing room, you cannot remove your shoes.
• Head coverings of any kind are not allowed in the testing room unless it is being worn for religious
purposes (such as hats, turbans, scarves, and yarmulkes). If the item is worn for religious purposes, it
will be visually inspected before you are admitted into the testing room and MUST remain in full view
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at all times. If you need to reposition or take o the head covering or religious item, you will be asked to
step out of the testing room and into the waiting area. All types of hair accessories, ties, and bow ties are
subject to inspection, and you may be prohibited from wearing them in the testing room.
• Jewelry outside of wedding and engagement rings is prohibited in the testing room.
DO I HAVE TO REQUEST A TESTING ACCOMMODATION TO BRING A
MEDICAL DEVICE SUCH AS A HEARING AID OR COCHLEAR IMPLANT,
INSULIN PUMP, OR DIABETES MONITORING EQUIPMENT INTO THE
TESTING ROOM?
A list of pre-approved personal items that do not require a request for testing accommodations is available
here. Candidates are not permitted to plug any device into the computer workstation. If the medical device
includes an accompanying external remote-control device, the remote-control device may not be taken into
the testing room without prior approval. If the device makes any kind of noise, you must request and be
approved for testing accommodations in advance. If the medical device includes an accompanying external
remote-control device and there is a need to take the external remote-control device into the testing room,
including a cell phone, candidates must apply and be approved for a testing accommodation to do so.
Please review the Testing Accommodations Handbook and contact acc[email protected]g to review
diabetic monitoring requirements, including the use of a cell phone for diabetic monitoring.
HOW MUCH TIME WILL I HAVE FOR THE EXAM?
The OTR and COTA exams are 4 hours long (this is your exam time). Your appointment time will be
longer than your exam time to allow time for check-in, exam tutorials, surveys, check-out, and other
administrative procedures (approximately 4 hours and 45 minutes). Please note, accepting the terms of the
Acknowledgment section prior to launching the exam is mandatory. If the terms are not accepted within
the seven minute time limit, the exam will automatically close and the appointment will be forfeited.
Candidates must then contact NBCOT at credentialingservices@nbcot.org to reissue their ATT letter for a
fee.
WILL THERE BE OTHER CANDIDATES TESTING AT MY TEST CENTER?
There will likely be other candidates taking dierent exams at your test center during your exam
appointment. The layout of the testing cubicles ensures you have ample workspace and privacy from other
test takers.
CAN I TAKE A BREAK DURING THE EXAM?
Yes, you may take breaks during the exam. However, the exam clock will continue to run while you are on
the break. You will be required to complete all check-in procedures to re-enter the testing room. This may
require waiting for other test takers to complete check-in procedures. Please note that candidates may not
exit the test center building while taking a break. Exiting the test center during your exam could result in
you being dismissed and the exam terminated. Exam fees could be forfeited and your future exam eligibility
status will be determined by NBCOT.
IS COMPUTER KNOWLEDGE NECESSARY?
No. The optional tutorial(s) that accompany the exams walk you through the process of selecting answers
and progressing through the exam on the computer. Tutorial time does not count toward your allotted exam
time. You can repeat the tutorial(s) if you wish. You can also view the exam tutorial(s) online in advance by
clicking here.
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CAN I TAKE NOTES DURING THE EXAM?
Note taking is not allowed during the tutorial, acknowledgement, or at any time before test time starts to
count down. You can request to use a wet marker note board from the test center sta during your exam. If
you require additional materials, you will need to wait for the test center sta to clean the originally-issued
note board before reusing it. Writing on your hand or anywhere on your body is strictly prohibited and a
violation of test center rules and the NBCOT Candidate/Certificant Code of Conduct.
Food and beverages, including water, are not permitted in the testing room. Food and beverages can be
stored in lockers and consumed in the test center waiting area.
DOES PEARSON VUE HAVE A POLICY REGARDING CONDUCT IN THE
TESTING CENTER?
Candidate conduct is addressed in Pearson VUE’s Candidate Rules Agreement. Any candidate who does
not follow test center regulations may be dismissed from the test center and the exam terminated. Exam
fees could be forfeited and your future exam eligibility status will be determined by NBCOT. In addition, an
NBCOT sanction may be imposed due to a violation of the NBCOT Code of Conduct.
WHAT CAN I DO IF THE COMPUTER MALFUNCTIONS WHILE I AM
TAKING THE EXAM?
You MUST alert the test center sta immediately. Sta will make every eort to remedy the situation as soon
as possible. The time spent to remedy the problem will not count as part of your exam time. Due to the
nature of the exam delivery system, all previously entered exam data is saved.
If the problem cannot be remedied within 30 minutes, you have the right to reschedule the exam for another
day within your eligibility period.
You must contact NBCOT at credentialingservic[email protected]g or 301-990-7979 (ask for credentialing
services) for rescheduling approval and instructions.
WHAT HAPPENS IF I EXPERIENCE AN ADMINISTRATIVE OR
TECHNICAL ISSUE DURING MY EXAM?
Examples of administrative or technical issues include: computer screen freezing, power failure, physical
disruption within the testing center, or the exam or approved testing accommodation is not available at the
scheduled time.
NBCOT cannot address any administrative or technical complaints with Pearson VUE if you did not first file a
complaint at the test center. Administrative or technical complaints submitted aer your pass/fail status is
posted will not be investigated.
The following procedures must be followed for your complaint to be reviewed.
Administrative or Technical Complaints Checklist:
1. ☐ I, the examination candidate, MUST file a complaint immediately with the test center sta or
before leaving the test center. Test center sta will file a case report.
2. ☐ I MUST request a confirmation of the complaint.
3. ☐ I MUST contact NBCOT by email at credentialingservices@nbcot.org within 24 hours aer the
incident occurred to describe the incident in detail and provide the case report number, if applicable.
4. ☐ NBCOT will confirm initial receipt of the complaint.
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ALL exam scores are held when an exam complaint is submitted. Exam results will NOT be
posted or released until the complaint has been fully investigated and resolved.
If you wait until AFTER your pass/fail status has been posted to submit your exam
administrative or technical complaint, your exam complaint will NOT be acknowledged.
Please note that all exam scores are held until the exam complaint has been fully investigated and resolved.
As a result, the posting of pass/fail status to the NBCOT website and the release of exam results to a state
board(s) may be delayed.
NBCOT will respond within 21 business days of receipt of the complaint. Aer you receive a decision from
NBCOT regarding the administrative or technical complaint, you have the right to appeal. You can only
appeal AFTER (1) you have already submitted a complaint, (2) NBCOT has reviewed the complaint, and (3) a
decision has been rendered.
Appeals must be sent in writing via traceable mail and must be received by NBCOT within 21 days of the
candidate’s receipt of NBCOT’s complaint response. The candidate will be notified of the status of the
appeal investigation within 30 days of receipt of the appeal.
After the Exam: Questions &
Answers
WHAT IS MY OBLIGATION TO MAINTAIN CONFIDENTIALITY AFTER I
TAKE THE EXAM?
The NBCOT certification exams and the items contained therein are protected by federal copyright law.
No part of an exam or NBCOT study materials may be copied, reproduced, or shared in any manner, in
part or whole, by any means whatsoever, including memorization, verbal, written, and/or electronic
transmission, which includes, but is not limited to, Facebook, Twitter, Instagram, cell phone, study tool
sharing sites, blogs, and discussion forums. Posting exam or study tool questions to social media or other
networking sites constitutes a test security and copyright violation as noted in Principles 2 and 9 of the
NBCOT Candidate/Certificant Code of Conduct. Violations of the NBCOT Code of Conduct are investigated to
determine appropriate disciplinary action.
HOW ARE THE EXAMS SCORED?
For information on how the certification exams are scored, please review the Foundations of the NBCOT
Certification Exams, which can be accessed at www.nbcot.org/foundations.
HOW WILL I GET MY EXAM RESULT?
Aer the administration of the exam, your exam will be scored by NBCOT. Scores are released according to
the NBCOT Exam Scoring Calendar. You can view your results through your MyNBCOT account aer the exam
has been scored.
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Candidates with a passing score: You will be notified via email when your exam result has been posted
online. You will receive a separate email with information about your certification benefits and how to
access/download your digital certificate, badge, and wallet card verifying Occupational Therapist Registered
(OTR) or Certified Occupational Therapy Assistant (COTA) certification within three weeks of receiving your
score. If you do not receive an email within this time frame, please send an email to [email protected]g that
includes your full name and certification number.
Candidates with a failing score: You will be notified via email when the exam result has been posted
online. Your feedback report will include the overall score along with domain-level performance information
and an explanation for interpreting your overall and domain-level performance. The information on the
domain areas is provided for diagnostic purposes only. The feedback report also includes answers to
frequently asked questions about the feedback report and preparing to retake the exam. Refer to the
“Retaking the Exam” section on page 32 of this handbook for additional information about reapplying to
take the exam.
If you are a U.S.-educated candidate who takes the exam within one year of graduating, NBCOT will report
aggregate pass/fail information (without names) to the U.S. occupational therapy education program from
which you graduated. NBCOT only provides program directors with a list of names of candidates who pass
the OTR or COTA certification exams.
Upon receipt of the feedback report, candidates who hold a state-issued limited or temporary
permit(s) or license(s) that allows them to practice are advised to immediately contact the
regulatory agency in that jurisdiction to determine whether their limited or temporary permit/
license remains valid. Since the laws and regulations of each jurisdiction vary, it is essential
that the regulatory agency is contacted directly.
Score information will not be released to anyone via telephone, fax, or email. Certification
numbers can be accessed through your MyNBCOT account.
A candidate’s name and score will not be released to any third party without the candidate’s
prior written consent unless required by law.
CAN I APPEAL MY EXAM RESULT?
You may appeal your exam result by following the procedures listed below.
Exam Appeal Procedures Checklist:
1. ☐ I, the examination candidate, MUST send an appeal letter that specifically states the reason(s) for
the appeal and why the appeal should be granted.
2. ☐ I understand that failing the exam alone is not suicient grounds for an appeal.
3. ☐ I understand that administrative and technical issues/complaints that were not addressed
according to procedure (see page 29) are not suicient grounds for an appeal.
4. ☐ The appeal letter MUST be sent to NBCOT by traceable mail with signature confirmation to the
address below and received within 14 days of the date the exam pass/fail results were posted. I
understand that NBCOT will not accept correspondence received aer this date or submitted via
email.
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5. ☐ I understand that NBCOT will not discuss my appeal by phone or email until the appeal letter is
received.
6. ☐ I understand that NBCOT will address communications to me only unless NBCOT receives written
authorization to do so with a third party. This authorization must include name, telephone number,
email address, and how long this authorization is in eect.
7. ☐ I understand that the examination and examination items are the sole property of NBCOT. Any
content pertaining to the examination will not be released under any conditions as part of the appeal
process.
8. ☐ I understand that I will receive a response from NBCOT within 21 business days of NBCOT’s receipt
of the appeal letter.
Appeal letters must be sent to NBCOT by traceable mail with signature confirmation to:
Attention: Vice President, Credentialing Services
One Bank Street
Suite 300
Gaithersburg, MD 20878
Candidates may appeal the decision in writing via traceable mail to the address above no later than 21 days
aer the candidate’s receipt of NBCOT’s response. Submissions must outline the grounds of the appeal,
including reasons why the appeal should be considered. Appeals received aer 21 days or submitted
via email, phone, or non-traceable mail will not be acknowledged or reviewed. Candidates will receive
notification from NBCOT regarding the status of the review within 30 business days of NBCOT’s receipt of the
written appeal.
Retaking the Exam
Candidates who fail the exam may reapply for another exam administration. The following information
relates to the reapplication process:
• The following waiting periods apply to all exams:
▷ Second or third attempt: 30 days from date of last exam administration
▷ Fourth through sixth attempt: 60 days from date of last exam administration
▷ Seventh attempt or higher: six months from date of last exam administration
• Candidates can apply 30 days before their next eligible exam date. The date you can reapply is listed
on your MyNBCOT dashboard.
• Candidates must submit a new exam application in order to retest. Candidates log in to their existing
MyNBCOT account and follow the steps to reapply. DO NOT create a new account. A $35 USD fee will be
assessed for duplicate accounts.
• The exam application, Score Transfer requests, Eligibility Confirmation notices, and any other services
are subject to all applicable fees.
• Candidates may request one free Score Transfer AND one free Eligibility Confirmation Notice ONLY
if ordered at the time the exam application is submitted. These requests do not transfer from one
application to the next. If multiple services are ordered with the exam application, each additional
service is subject to a $35 USD fee. AFTER the exam application is submitted, Score Transfer or
confirmation notice requests are $35 USD each.
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• If candidates have a name change since the last exam administration, they MUST complete a Name
Change Request through their MyNBCOT account. This should be done before reapplying for the exam.
See the “Exam Day: Questions & Answers” on page 26 of this handbook for acceptable forms of ID to
be admitted to the test center.
• Candidates do not need to submit another transcript, unless requested by NBCOT.
• Candidates who previously tested with testing accommodations should refer to the Testing
Accommodations Handbook for details on how to reapply with TA.
• Candidates who previously answered “Yes” to a character question and were cleared for the exam
MUST answer the appropriate character question(s) on the exam application airmatively each time
a new application is submitted. If the airmative response is in reference to the same issue that
NBCOT previously reviewed, and no further incidents have occurred, the candidate MUST send written
confirmation of this to professional.c[email protected]g aer reapplying. The candidate will not need
to resubmit any previously submitted documentation.
• If there have been additional incidents or further action resulting in an additional airmative answer
to one or more of the character questions, the candidate MUST answer the appropriate character
question(s) airmatively and submit information regarding the new incident to NBCOT for review. If
the candidate fails to inform NBCOT, disciplinary action may result. Notifications should be sent to
professional.[email protected]g.
• Aer eligibility is approved, candidates will receive a new ATT letter with a new 90-day testing
eligibility period. The eligibility will begin no sooner than the applicable waiting period from your
previous test date.
• Aer receiving the ATT letter, candidates should schedule their exam directly with Pearson VUE as
instructed in the ATT letter. (See “Scheduling the Certification Exam” on page 19.)
NBCOT Certification Renewal: Keep
Your Credential Active
Candidates who take and pass the certification exam will have an initial renewal date that is four years
from the year they passed the exam. Aer their first renewal, they will enter a three-year renewal cycle
for all subsequent renewals. This creates an equal opportunity for new certificants to earn professional
development.
The certification renewal season occurs between January and March annually, regardless of the month
the initial certification was received. For example, students who pass the exam in 2024 will have their first
renewal take place during January through March 2028. Aer their first renewal, they will enter the three-
year renewal cycle and be scheduled to renew between January and March 2031.
The requirements for certification renewal are:
• Accrual of required units: Certificants must accrue 36 units in the time between their initial certification
date and the date that they are due to renew their certification
• Abidance by the NBCOT Practice Standards/Code of Conduct
• A completed certification renewal application
• The appropriate renewal application fee
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Certification renewal is required to maintain active certification. Fulfilling the certification renewal
requirements entitles a certificant to continue using the OTR or COTA credential.
Why Renew?
When an OTR or COTA renews their national certification, it shows that they place value in professional
development and evidence-based practice. One benefit of certification renewal is the continued use of
the NBCOT credential. To identify yourself to the public using the OTR or COTA certification marks, your
certification status must be active and in good standing. The OTR and COTA credentials are representative
of practitioners who satisfy national standards in education, experience, and professional conduct, and
demonstrate that they possess the knowledge and skills to be accountable for the delivery of professional
services.
NBCOT Navigator®
Another benefit of certification is continual access to the latest evidence-based research through the NBCOT
Navigator suite. The NBCOT Navigator is a set of interactive tools that enable you to demonstrate knowledge
of contemporary practice and sharpen your skills using interactive case simulations, games, and mini
practice quizzes. By renewing your certification you will also receive 24/7 access to ProQuest
®
and RefWorks
®
in order to stay on top of current developments and trends in occupational therapy research. For more
information on the Navigator suite, visit nbcot.org/navigator.
How to Renew Certification
There are two ways to renew certification:
1. Log in to your MyNBCOT account online.
2. Complete and mail in a paper application.
Prior to a certificant’s renewal due date, NBCOT sends a courtesy reminder notification and renewal
instructions. For this reason, it is essential that certificants keep all of their contact information updated
with NBCOT. You can update your information at any time by logging in to your MyNBCOT account. Select
Edit Profile in the drop down menu under your name.
You will receive an email with information on how to access/download you digital certificate, badge, and
wallet card within three weeks aer your renewal application is processed. For complete details on the
renewal process, visit the renewal section of the website.
Summary of Exam Candidate Service
Requests
• Name change: Log in to your MyNBCOT account and select Name Change in the drop-down menu
under your name. Upload a copy of one form of government-issued ID reflecting the name change
(e.g., driver’s license, state-issued ID, military ID, passport, or signed social security card). Proceed
through checkout and pay any necessary fees as applicable. See “Name Change” on page 20.
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• Repeat exam candidates: A new application and fee must be submitted. Log in to your existing
account – do not create a new one. One free Score Transfer and/or one free Eligibility Confirmation
Notice may be requested at the time of exam application submission. Fees apply to any additional
request(s). See “Fees” on page 17.
• Mailing address change: Candidates can update their address online at any time through their
MyNBCOT account. A valid street address is required for the background check. The address on file is
the address used to send important NBCOT certificant correspondence. See “Address Change” on page
20.
• Email address change: Candidates can update their email address through their MyNBCOT account. It
is the candidates’ responsibility to keep their email address current with NBCOT.
• Reissue of ATT letter: The ATT letter is active for 90 days. If the exam is not taken within the 90-
day period, the ATT letter can be reissued for an additional 90 days if requested while the exam
application is still active (unexpired). Reissue of an ATT letter may be requested online through the
MyNBCOT account. See “Authorization to Test (ATT) Letter” on page 18.
• Score Transfer request to state regulatory boards: Request by logging in to your MyNBCOT account
and selecting the service. One free Score Transfer is included with your exam application submission.
The fee is $35 USD for each additional request. See “Score Transfer” on page 16.
• Eligibility Confirmation Notice: Request by logging in to your MyNBCOT account and selecting the
service. One free confirmation notice is included with your exam application submission. The fee is $35
USD for each additional request. See “Eligibility Confirmation Notice” on page 17.
• If an exam candidate has been convicted of a felony at any time before or aer issuance of an
Authorization to Test (ATT) letter: Based on Practice Standards/Code of Conduct that the candidate
must agree to when signing the exam application attestation statement, the candidate must notify
NBCOT of a felony conviction. If the candidate fails to inform NBCOT, disciplinary action may result.
See “Exam Certification Eligibility Requirements” on page 9.
Exam Application Procedures
Checklist
Completing the NBCOT Exam Application and Submitting Fees:
☐ I have read the NBCOT Certification Exam Handbook.
☐ Graduates with an accredited U.S. entry-level occupational therapy degree: I am cleared for
graduation (i.e., graduation is certain) or I have been awarded the degree, and I have completed the
required fieldwork BEFORE submitting my exam application.
☐ If applying online for the first time, I have set up a new account with my working email address, valid
street address, and password.
☐ If I have an existing online account from a previous application or I am a COTA applying for the OTR
exam, I have logged in with my email and password and I will follow the steps to reapply.
☐ If I want NBCOT to send a Score Transfer or Eligibility Confirmation Notice to a regulatory entity or
employer, I have indicated so on my application. To receive my one free Score Transfer and/or my
one free Eligibility Confirmation Notice, I must request the service(s) at the time I submit this exam
application.
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☐ I have paid all applicable fees.
☐ I have saved the receipt/invoice for my records as proof of successfully submitting the application.
Changing My Name
☐ If I have had a name change at any time prior to taking the certification exam, I have submitted a
Name Change Request, uploaded the appropriate legal documentation, and paid any applicable fees.
Graduates with an Accredited U.S. Entry-level Occupational Therapy Degree:
☐ I have requested my registrar to submit my oicial final transcript to NBCOT through a secure
electronic document transfer service or in a sealed envelope. Note: This must be requested AFTER
your NBCOT account is created.
☐ If submitting a DVF, I have requested that my program director approve my DVF and send to my
college/university registrar to sign, seal, and send the DVF to NBCOT within six (6) months of my
anticipated graduation date, having successfully completed all degree and graduation requirements,
including occupational therapy education, Level I and Level II Fieldwork, and, for OTD students, the
doctoral capstone experience and project. The form may only be used within the same calendar year
as my anticipated graduation date. See “Degree Verification Policy” on page 15.
Requesting Testing Accommodations
☐ I have read the NBCOT Testing Accommodations Handbook.
☐ If I have a professionally diagnosed disability covered by the Americans with Disabilities Act (ADA)
and I wish to request testing accommodations, I have done so through my exam application and have
submitted all required documentation.
Character Review
☐ If I answered “Yes” to a character question, I have submitted the required documentation.
Scheduling the Exam with Pearson VUE
☐ I have received my ATT letter and I have contacted Pearson VUE to schedule my appointment.
☐ If I need to cancel/reschedule my exam date, I will follow the procedures outlined in the cancellation
policy. See “Cancellation, Reschedule, Late Arrival, No Show Policy” on page 21.
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