Occupational Therapist Registered OTR

Certification Examination
for Internationally-Educated Candidates

Handbook

2013

NBCOT Certification Programs are accredited by:

This publication is intended solely for the use of internationally-educated candidates applying to take the NBCOT Certification Examination in 2013. 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. For the most up-to-date information concerning the certification examinations, please visit www.nbcot.org, e-mail: info@nbcot.org, call 301-990-7979 or fax: 301-869-8492.

AOTCB/NBCOT 2013 Examinations

ID 34 rev120612

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. 2013 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. 12 South Summit Avenue, Suite 100 Gaithersburg, MD 20877 http://www.nbcot.org Printed in the United States of America.

TABLE OF CONTENTS
Introduction About NBCOT......................................................................................................................... 2 About This Handbook.............................................................................................................. 2 Purpose of the Examinations................................................................................................. 2 Examination Development..................................................................................................... 2 Examination Administration................................................................................................... 3 Certification Eligibility Requirements Certification Eligibility Requirements..................................................................................... 3 Eligibility Appeal Process........................................................................................................ 3 NBCOT Candidate/Certificant Code of Conduct .................................................................. 4 Application Process Submitting the Application..................................................................................................... 6 Online Application for First Time Exam Candidates......................................................... 6 Hardcopy Application for First Time Exam Candidates.................................................... 7 Character Questions............................................................................................................... 7 Reporting Services.................................................................................................................. 8 Confirmation of Exam Registration/Eligibility of Exam Notice........................................ 8 Official Score Transfer........................................................................................................ 8 Fees.......................................................................................................................................... 9 Special Testing Accommodations.......................................................................................... 9 Taking the Spanish OTR Certification Examination............................................................. 9 Approved Applications Authorization to Test (ATT) Letter......................................................................................... 10 Checking Exam Application Status...................................................................................... 10 Scheduling the Certification Examination........................................................................... 11 Biometric Candidate Notice During Scheduling/Registration............................................ 11 Name and/or Address Changes........................................................................................... 12 Application Withdrawal and Refund For Personal and/or Medical Emergencies............. 13 Cancellation, Rescheduling, Late Arrival or No Show for Scheduled Examination........... 13 NBCOT Exam Products and Service Refund Policy............................................................. 14 Preparing for the Exam Examination........................................................................................................................... 15 Multiple Choice Items...................................................................................................... 16 Simulation Test Items...................................................................................................... 16 Study Tools............................................................................................................................ 17 Exam Day: Questions & Answers............................................................................................ 18 After The Exam: Questions & Answers................................................................................... 21

Retaking the Exam..................................................................................................................23

NBCOT Certification Renewal: Keep Your Credential Active!.............................................. 24 Summary of Exam Candidate Requests................................................................................. 25 Appendix....................................................................................................................................26

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. The mission of NBCOT is to serve the public interest by advancing client care and professional practice through evidence-based certification standards and the validation of knowledge essential for effective practice in occupational therapy. NBCOTs vision is certified occupational therapy professionals providing effective evidencebased 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 have received and maintained accreditation by the American National Standards Institute (ANSI) and the National Commission for Certifying Agencies (NCCA). NBCOT is a proud member of the Institute for Credentialing Excellence (ICE).

About This Handbook

This handbook has been developed to provide internationally educated exam candidates with the information to complete and successfully submit a certification examination application. NBCOT recognizes the responsibility exam candidates take when completing their exam application. Our aim is to provide a smooth and positive application experience.

Visit www.nbcot.org for a list of Frequently Asked Questions regarding the certification examination and application. Questions can be directed to info@nbcot.org, or by phone (301) 990-7979.

Purpose of the Examinations

The primary purpose of the NBCOT certification examinations 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 examinations are constructed to measure entry-level competence of candidates who have met eligibility requirements for OTR certification.

Examination Development
The OTR examinations are constructed based on the results of practice analysis studies. The studies identify the domains, tasks, knowledge and skills required for occupational therapy practice relative to the OTR credential. The ultimate goal of a practice analysis study is to ensure that there is a representative linkage of examination content to practice. The periodic performance of practice analysis studies assists NBCOT with evaluating the validity of the test specifications that guide content distribution of the credentialing examinations.

Page 2

www.nbcot.org

Examination Administration
The NBCOT certification examinations are administered at Prometric Test Centers (PTCs) worldwide. Prometric delivers and administers more than 10 million tests a year on behalf of approximately 400 clients in the academic, financial, government, healthcare, professional, corporate and information technology markets. It delivers test flexibly via the Web or by utilizing a robust network of more than 10,000 test centers in more than 160 countries. For more information, please visit www.prometric.com.

Visit NBCOT on Facebook www.facebook.com/NBCOTCertification Visit NBCOT on Twitter www.twitter.com/NBCOT Visit NBCOT on LinkedIn www.linkedin.com/groups?gid1140837

Certification Eligibility Requirements

Certification Eligibility Requirements
Graduating with an accredited/approved entry-level occupational therapy degree - Masters degree in occupational therapy OTR exam Completing all fieldwork requirements Agreeing to abide by the NBCOT Code of Conduct Attaining a passing score on the NBCOT OTR certification examination

Eligibility Appeal Process

If a candidate is determined to be ineligible to take the certification examination, the candidate has the right to appeal that decision in writing to the NBCOT Board of Directors. Within 21 days of receipt of the ineligibility notification, the candidate may submit a letter of appeal. The letter MUST outline the grounds for the appeal, including reasons why the application should be recognized and accepted by NBCOT. All letters should be sent via traceable mail (i.e., certified, UPS, Federal Express) to: NBCOT, Inc. Attn: President and Chief Executive Officer 12 S. Summit Avenue, Suite 100 Gaithersburg, MD 20877

www.nbcot.org

Page 3

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 professional responsibilities for present and future NBCOT certificants, i.e., OCCUPATIONAL THERAPIST REGISTERED OTR (OTR) henceforth OTR, and CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA (COTA) henceforth COTA. It is vital that NBCOT certificants conduct their work in an appropriate and professional manner to earn and maintain the confidence and respect of recipients of occupational therapy, colleagues, employers, students, and the public. As certified professionals in the field of occupational therapy, NBCOT certificants will at all times act with integrity and 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 with fairness and honesty, abide by all federal, state, and local laws and regulations, and encourage others to act in a professional manner consistent with the certification standards and responsibilities set forth below. Where the term certificant is used, the term applicant or candidate is included in its scope.

Principle 1
Certificants shall provide accurate and truthful representations to NBCOT concerning all information related to aspects of the Certification Program, including, but not limited to, the submission of information: On the examination and certification renewal applications, and renewal audit form Requested by NBCOT for a disciplinary action situation Requested by NBCOT concerning allegations related to: test security violations and/or disclosure of confidential examination material content to unauthorized parties; misrepresentations by a certificant regarding his/her credential(s) and/or education; the unauthorized use of NBCOTs intellectual property, certification marks, and other copyrighted materials.

Principle 2
Certificants who are the subject of a complaint shall cooperate with NBCOT concerning investigations of violations of the Candidate/Certificant Code of Conduct, including the collection of relevant information. (continued)

Page 4

www.nbcot.org

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 relates to their professional work, education, professional credentials, research and contributions to the field of O.T.

Principle 4
Certificants shall comply with laws, regulations, and statutes governing the practice of occupational therapy.

Principle 5
Certificants shall not have been convicted of a crime, the circumstances of which substantially relate to the practice of occupational therapy or indicate an inability to engage in the practice of occupational therapy safely, and/or competently.

Principle 6
Certificants shall not engage in behavior or conduct, unlawful or otherwise, that cause(s) 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, students or colleagues.

Principle 7
Certificants shall not engage in the practice of occupational therapy while ones ability to practice is impaired due to chemical (i.e., legal and/or illegal) drug or alcohol abuse.
Approved June 2002 copyright 2011, NBCOT, Inc. Revised February 2003 Revised June 2006 Revised October 2008 Revised January 2010 Revised November 2011

www.nbcot.org

Page 5

Application Process
Submitting the Application
There are two ways to apply for the certification examination online or by mail using a hardcopy application. An application is valid for one year from date of submission.

Important Note:
The candidate must complete the application. Applications submitted for the candidate by anyone other than the candidate are not valid. This includes, but is not limited to, family members, program directors, fieldwork coordinators and other professors. The candidate will be deemed ineligible for one (1) year and the fees forfeited. Candidates who do not take their exam within one year of the date they apply will need to submit a new application with exam application fee. After one year, the exam application expires and the fee is forfeited.

Online Application for first-time exam candidates:

Step 1: Read the instructions outlined in this handbook Step 2: Set up a new account by logging onto www.nbcot.org and then, completing the Online Application On the home page, select Certification Candidates from the top menu bar Select Online Exam Application from the drop down menu Read through the opening instructions Click Apply Now Click the Setup New Account link Complete the Exam Application Account Setup page. Online candidates MUST provide a working e-mail address that is capable of receiving e-mail from NBCOT Click Continue to Exam Application On the Application Welcome Page, click Continue. Proceed through each screen of the application, carefully following the on-screen instructions and providing all information required. Graduates of an international occupational therapy education program, or with combined education (i.e., international and U.S.) should apply for the exam as an international candidate. An exam application, including payment section, MUST be completed in its entirety in one session in order to be saved. Partially completed applications cannot be saved in the online system. Once a candidate has registered online, they can log onto their account using the username (e-mail address) and password that was created when the account was initially set up. Candidates may make changes to their username, password, and address by logging on to the account and clicking the Edit Info button on the application. Address changes cannot be made once the online exam application has been pre-approved.

Important Notes:
An online account should only be created once. A fee will be assessed if a duplicate account is created. If a candidate has forgotten their username or password, they may get this information by contacting NBCOT via e-mail at onlineexamapp@nbcot.org. Do not set up another account! A fee will also be assessed for any corrections made to the online exam application after the exam application has been submitted. www.nbcot.org

Page 6

Hardcopy Application for first-time exam candidates

A hard copy exam application can be downloaded from the NBCOT website, and is also located in appendix B of this handbook. Step 1: Read the instructions outlined in this handbook Step 2: Complete all applicable sections of the application. Under the exam application Section 3: Exam Eligibility Pathway select the checkbox for OTED A signature is required on the Attestation Statement. Make a photocopy of the completed application for your records. Step 3: Mail the application, along with payment to: NBCOT, Inc. P.O. Box 64971 Baltimore, MD 21264. NBCOT recommends that the application be sent via traceable mail (e.g. certified). If a working e-mail address (username) and password were provided in the application, the candidate can use them to check the status of the application online at www.nbcot.org.

Important Note:
Candidates should not apply online if a hardcopy application has been submitted.

Character Questions
This section MUST be completed by all candidates. If a candidate answers yes to any of the character questions on the application, the following information MUST also be submitted: 1. A written explanation of the events regarding the incident or question to which yes was answered. 2. Copies of any official documentation related to the incident, including police reports showing the initial charge(s), court documents showing sentencing requirements or documents showing how the case was resolved, e.g., dismissed, pre-trial program. 3. Any additional information or documentation, such as remedial measures taken since the incident including letters from parole or probation officers confirming successful completion of probation, or a letter confirming successful completion of chemical dependency treatment. For initial felony charges or felony convictions, candidates MUST answer affirmatively and submit supporting documentation, even if records, charges, or convictions have been pardoned, expunged, pled down, released, or sealed. All information MUST be submitted to and reviewed by NBCOT before the examination application will be approved. If an exam candidate has been charged with and/or convicted of a felony at any time before or after issuance of an Authorization To Test (ATT) letter, the candidate MUST notify NBCOT immediately. If the candidate fails to inform NBCOT, disciplinary action may result. Notifications should be sent to: NBCOT, Inc. Attn: Qualifications and Compliance Review 12 S. Summit Avenue, Suite 100 Gaithersburg, MD 20877 www.nbcot.org
Page 7

Reporting Services
NBCOT offers the following reporting services: Confirmation of Examination Registration and Eligibility to Examine Notice Official Score Transfer

The candidate is responsible for contacting the occupational therapy state regulatory board to determine which service(s) is required.

Confirmation of Examination Registration and Eligibility to Examine Notice

This service confirms that a candidate has, in fact, applied for and been deemed eligible to take the national certification examination. This service requests NBCOT to send a confirmation notice to any third party (a U.S. state regulatory board if seeking a temporary/limited permit, employer, etc.) or to a candidate who wishes to have a notice for their personal records. There is a fee per notice. The notice contains the following confirmations: 1. Examination application and fees have been processed 2. Official final transcript has been received & accepted 3. Candidate has been approved to schedule a test date with Prometric 4. Candidates examination history: a listing of the dates of examinations, 1997 - present

Important Note:
All states accept the Confirmation of Examination Registration and Eligibility to Examine Notice except: Alabama, Colorado, Connecticut, Hawaii, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, New Hampshire, North Carolina, South Carolina, Washington, and Wisconsin.

Official Score Transfer

This service requests NBCOT to send an Official Score Transfer (also known as the Score Report) to a U.S. state regulatory board. A state regulatory board will NOT automatically receive a score report unless an official score transfer service has been ordered. There is a fee for each score report sent.

Important Notes:
The cost of this service increases after the exam has been taken. All states accept scores except: Hawaii. Completion of the NBCOT Certification Examination Application is not the same as applying for state licensure. Sending a score report to a state regulatory board does not automatically initiate the process to obtain a license or permit to work in that state. Certification by NBCOT is independent, different, and separate from any state or jurisdictions 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. www.nbcot.org

Page 8

Ordering reporting services at time of application: Select the service on the application. Candidates may log onto their online exam application to add services while the application is in New status but cannot remove or substitute services. For example, a score report request to a state may not be removed or substituted for a score report to another state. Ordering reporting services after the exam application has been submitted: Candidates should contact NBCOT to order additional reporting services. Ordering reporting services after exam has been taken: If an applicant orders a reporting service after the exam has been taken, the candidate MUST submit the appropriate request form with payment to NBCOT. Forms for reporting services can be found at:

www.nbcot.org > Forms > NBCOT Certification Examination Forms > North America.
Ordered items cannot be cancelled or refunded.

Important Note:
All reporting service requests are final and non-refundable. After an exam application has been submitted, a fee will be assessed for requests to remove a reporting service and for any other changes or corrections made to the online exam application. If an applicant orders a reporting service after the exam has been taken, the applicant must submit the proper request form with payment to NBCOT.

Fees
Payment for examination applications and related services such as score transfer, confirmation of exam registration, and eligibility to examine notices must be made by credit card (MasterCard or Visa). Candidates applying for the OTR examination MUST pay the fee at the time the application is submitted. No off-line payments will be accepted. An application cannot be processed until all fees are paid in full. For a detailed fee schedule, see the payment section of the application in Appendix B of this handbook. Questions can be directed to NBCOT via e-mail at onlineexamapp@nbcot.org or by phone at 301-990-7979.

Special Testing Accommodations (for Testing in the U.S. Only)

In adherence with the Americans with Disabilities Act (ADA, 1990, updated 2010), NBCOT will provide reasonable and appropriate accommodations for eligible candidates with a diagnosed disability who submit appropriate documentation. Refer to the Special Testing Accommodations handbook at: www.nbcot.org > Forms > Special Accommodations for details on requesting testing accommodations. Direct specific questions to: accommodations@nbcot.org Please note, a request for special testing accommodations approval may increase the amount of time it takes to process an exam application.

Taking the Spanish OTR Certification Examination

Candidates may choose to take the OTR examination written in American Spanish. Candidates wishing to take the examination written in American Spanish MUST: Select the option to take the examination in American Spanish on the certification examination application (section 7 of the application). Candidates who submit an exam application and later request the American Spanish version will be required to pay an additional fee. www.nbcot.org
Page 9

Approved Applications
Authorization to Test (ATT) Letter
Once a candidates eligibility has been approved by NBCOT, the candidate will receive an Authorization to Test (ATT) letter by e-mail (or regular mail, if no e-mail address was provided on the application). The ATT letter authorizes the candidate to take the certification examination.

Important Note:
The ATT letter will include: The contact information for Prometric and details on how to schedule an examination Information on how to reschedule or cancel an examination if necessary The ATT Letter will be sent within 10-15 business days of receipt of all required documentation. It is the candidates responsibility to keep their e-mail address current with NBCOT.

The ATT letter is active for 90 days. If the candidate does not take the examination within this 90-day period, the candidate may choose to reactivate the ATT letter for an additional 90 days. The ATT letter can be reactivated as many times as necessary during the one-year application period. There is a fee for each reactivation of the ATT letter. After one year, the ATT letter can no longer be reactivated a new examination application and fee MUST be submitted. Reactivation of the ATT letter may be requested online if the account is in Reactivate Status, by logging onto the candidates account, or by submitting a Reactivation/Reissue of Authorization to Test (ATT) Form, available on the NBCOT website at:

www.nbcot.org. > Forms > NBCOT Certification Examination Forms > Reactivation/Reissue of Authorization to Test (ATT) Form.
Once a candidate submits a Reactivation/Reissue of Authorization to Test (ATT) form, the original ATT letter is voided. The candidate may no longer test on the original ATT letter.

Checking the Examination Application Status

Candidates may log into their examination application account to check the application status by using the same login (e-mail and password) created at initial account setup. Candidates can check to see whether payment has been received, the transcript has been received (not required if the candidate has completed the OTED process), or the ATT letter has been sent. It is the candidates responsibility to check to see if the ATT letter has been sent to them online. Candidates can view and print a copy of their current ATT letter from their account. Those who do not have an e-mail address or password can call NBCOT and the ATT letter will be re-mailed if the ATT letter has not yet been received.

Important Note:
NBCOT will only release information pertaining to an exam application's status directly to the exam candidate.

Page 10

www.nbcot.org

Pictured above and at right: a Prometric test center.

Scheduling the Certification Examination

After the ATT letter has been received, candidates can schedule their testing appointment directly with Prometric. A list of Prometric test centers can be found online at www.prometric.com. Candidates are encouraged to locate a test center and schedule their examination online. If a candidate chooses to call Prometric instead, the call center should be contacted, rather than the individual Prometric test center. Prometrics contact information will be included on the candidates ATT letter. NBCOT cannot schedule or confirm individual exam appointments.

Important Notes:
Please DO NOT contact Prometric until after you have received the ATT letter.

Biometric Candidate Notice During Scheduling/Registration

Whether scheduled online or via phone, the candidate will be presented with a biometric-enabled check-in notice. This notice will explain the collection and usage of biometric information. The candidate MUST acknowledge having read the statement by selecting agree or disagree either selection will allow the candidate to proceed with registration.

Important Note:
If an exam candidate calls to schedule the exam over the phone, the Prometric customer service representative will read a brief statement about biometrics and direct the candidate to the website for further information. Upon completion of the scheduling process, an exam confirmation e-mail will be sent containing a link to the website featuring further information about biometric-enabled check-in.

www.nbcot.org

Page 11

Name and/or Address Changes

The first and last names provided on the examination application is the name that is printed on the Authorization To Test (ATT) letter. Candidates are required to present identification when arriving at the Prometric Test Center. This identification MUST match the first and last names indicated on the ATT letter. The middle initial does not show on the ATT letter and is not required for ID purposes. If the identification does not match the ATT letter, the candidate will not be admitted to test, and the examination will be forfeited. When the exam is forfeited, the ATT letter is voided; a new ATT letter is required. Name changes cannot be made at the test center.

Name Change (First-time Candidates)

If a candidates legal name changes AFTER the examination application has been submitted, the new name MUST be updated with NBCOT. To request a name change BEFORE the exam application account is pre-approved: Complete a Name Change Request Form available online at:

www.nbcot.org > Forms > Certification Related Forms > Misc. Forms >Name Change Request Form.
Submit copies of the legal documentation that reflects the name change. See request form for list of accepted documents. Mail or fax form and documentation to NBCOT, at the address listed on the form. The name given on the examination application is the name printed on the Authorization To Test (ATT) letter. To request a name change AFTER the ATT letter is issued: Complete a Reactivate/Reissue of ATT letter Form available online at: www.nbcot.org > Forms > NBCOT Certification Examination Forms> North America > Authorization To Test Letter (reactivation). Be sure to include the reactivation fee. Submit copies of the legal documentation that reflects the name change. See request form for list of accepted documents. Mail or fax forms, payment, and documentation to NBCOT, at the address listed on the form.

Name Change (Retake Candidates)

Candidates who need to retake the certification examination and who have had a legal name change since the last exam administration MUST contact NBCOT by telephone or e-mail for instructions prior to submitting the online exam application. Candidates do not have the ability to change their name online. If a candidate reapplies with payment prior to NBCOT updating their record, the application becomes pre-approved in the previous name. Those who reapply online PRIOR to contacting NBCOT, will be assessed an administrative fee to correct the name in the online account. Payment in the form of a check, money order, or credit card (Visa/MasterCard) will be required with submission of the Name Change Request Form and proper name change documentation to NBCOT. Candidates submitting paper exam applications can submit name change documentation, along with exam fees to NBCOT. www.nbcot.org

Page 12

Address Change
When a candidates address changes AFTER the exam application has been submitted, the candidate can update their address information at the Prometric testing center on the day of their exam, or by calling NBCOT when the online pass/fail scoring information has been uploaded. Address changes can only be made to the application BEFORE the exam application account is pre-approved/processed. Candidates who apply online are encouraged to access their application online to update their address. Address changes cannot be made to the online application once the ATT letter has been issued. The next opportunity to change an address is at the Prometric test center on the day of the examination. Address changes may also be made if and when an ATT letter is reactivated/reissued. Please be sure to set up a forwarding address with the postal service.

Application Withdrawal and Refund For Personal and/or Medical Emergencies

Candidates whose exam has been scheduled, and whom experience a personal or medical emergency, MUST notify NBCOT in writing. Documentation verifying the event/circumstance MUST be provided. Requests for rescheduling of the exam will be considered on a case by case basis. Approved candidates will receive a partial refund. Since the examination application remains active for one year, in order to receive a partial refund, the candidate MUST completely withdraw the examination application within a year of the application date and submit the request via e-mail to info@nbcot.org with a brief explanation. Refunds will be processed within 30 days from the date NBCOT approves the refund request.

Cancellation, Rescheduling, Late Arrival or No Show for Scheduled Examination

The following fees apply to examination candidates who reschedule, cancel, arrive late or do not appear for their scheduled examination:
Category 1 Cancellation/Reschedule Period 30 or more business days before scheduled examination date Cancellation/Rescheduling Fee No fee. If exam is rescheduled within current ATT letter activation period, no Reissue/Reactivation Notice form is required. $35.00 (contact Prometrics Candidate Services Contact Center). If exam is rescheduled within current ATT letter activation period, no Reissue/Reactivation Notice form is required. $175.00 - See NBCOT website (www.nbcot.org) for an ATT Reissue/Reactivation Notice order form. This form MUST be completed and submitted to NBCOT with payment before the exam can be rescheduled.

5-29 business days before scheduled examination date Less than 5 business days before scheduled examination date; or Fails to appear for a scheduled examination; or Arrives at the Test Center more than fifteen (15) minutes after scheduled examination start time for taking the examination and is refused admission Arrives at the Test Center without the proper ID

Candidates with Category 1 or 2 changes MUST make and confirm all cancellations/changes through direct contact with Prometrics Candidate Services Contact Center (CSCC) personnel. Leaving a message on a recorder or a voice mail is NOT an acceptable means to confirm cancellation or examination date change.

www.nbcot.org

Page 13

NBCOT Exam Products and Services Refund Policy

Fees for these services are non-refundable

Official Score Transfer* Confirmation of Examination Registration and Eligibility to Examine Notice Authorization to Test (ATT) Reactivation/Reissue Online Practice Tests Online Content Tests OTKE Study Guides
*Exception: If the examination application is withdrawn, the Official Score Transfer fees will be refunded.

Page 14

www.nbcot.org

Preparing for the Exam

Examination
The OTR examination consist of 3 Simulation Test Items and 170 Multiple Choice Test Items. The questions are derived from the result of practice analysis studies and developed to measure the knowledge required for practicing as an entry-level occupational therapist registered. The following chart presents the domain areas and proportion of test items established for the OTR blueprint of the current certification examination. OTR Domain Descriptions
01 02 03 04 Gather information regarding factors that influence occupational performance Formulate conclusions regarding the clients needs and priorities to develop a client-centered intervention plan Select and implement evidence-based interventions to support participation in areas of occupation (e.g., ADL, education, work, play, leisure, social participation) throughout the continuum of care Uphold professional standards and responsibilities to promote quality in practice

Percent of Exam
13% 28% 39% 20%

Validated Domain, Task, Knowledge and Skill Statements for the Examinations
There are multiple task, knowledge, and skill statements for each domain area of the credentialing examination. The OTR Validated Domain, Task, Knowledge and Skill Statements for the examination is available online at:

www.nbcot.org > Certification Candidates > Certification Candidates FAQ > Where can I obtain more detailed information about the areas tested on the examinations?

www.nbcot.org

Page 15

Multiple Choice Items

Each multiple choice item starts with a stem or premise. This is usually in the form of a written statement or question. Possible response options are listed beneath the stem. From the options listed, there is only ONE correct response, the other options are distracters. Candidates need to solicit the best response based on the information presented in the stem. Example: During which task would a stereognosis deficit secondary to a CVA be MOST EVIDENT? 1) Getting coins from a pocket* 2) Pouring water into a cup 3) Putting on a pair of socks 4) Opening a pill bottle *Correct answer

Simulation Test Items

A simulation test item consists of an opening scene, sections with section headers, and a list of decisions or action statements. These action statements consist of positive, negative, and neutral statements. An example is shown at right. Candidates select the actions that they deem appropriate from the list of actions provided. As the action statement is selected, a feedback box will appear. Feedback is revealed response-by-response as the candidate makes each selection, so that a candidate only receives information on the actions they have chosen throughout the course of the problem. Feedback does not give information on how well a candidate did on the item. From the list of actions, a candidate will score points for positive actions and have points deducted for actions that are negative or hinder the resolution of the presented problem(s). A candidate will neither have points awarded nor deducted for selecting a neutral action. Once an action has been selected it cannot be de-selected. Candidates are able to navigate back to see previous screens; however, actions cannot be added to previous screens once the candidate has progressed to a new screen.
Page 16 Pictured above: screenshot similar to the format that appears on the exam.

www.nbcot.org

Study Tools
NBCOT offers a number of study tools to assist candidates with their exam preparation including the validated domain, task, knowledge and skill statements, the examination blueprints, entry-level self-assessment tools, online practice tests, study guides, and study packages. The tools are designed to help candidates assess their examination readiness, focus study efforts in appropriate areas, and become familiar with the areas tested on the examination. NBCOT does not guarantee enhanced performance on the NBCOT certification examinations for those using any of these study materials. However, the official NBCOT study tools are the only OTR certification examination study tools designed exclusively by NBCOT test development professionals and include sample practice questions that have been written to the same psychometric standards as the actual NBCOT certification examinations.

Study Tools Central

NBCOT

To access the study tools, click on the Study Tools Central button at left, or on the NBCOT home page at www.nbcot.org

Important Note:
NBCOT does not administer, approve, endorse, or review preparatory courses relating to the NBCOT certification examinations or study materials produced by other vendors.

NOW Accessible From Mobile Devices Entry-Level Self-Assessment Tools

www.nbcot.org
Page 17

Exam Day: Questions & Answers

What are the requirements for admission to the test center?
You MUST arrive 30 minutes prior to your scheduled appointment with two forms (two primary forms or a primary and secondary form) of acceptable identification where your name and signature match your ATT letter.

Acceptable Primary identification is:

A currently valid, government-issued photo ID with legal name and legible signature. Requirement Current issue date Current issue date Current issue date Current issue date Current issue date Requirement Legal name Legal name Legal name Legal name Legal name Requirement Signature Signature Signature Signature/barcode Signature/barcode Requirement Photograph Photograph Photograph Photograph Photograph Primary ID Drivers License Passport State Issued ID Permanent Resident/ Green Card Military ID

Acceptable Secondary identification is:

A current major credit card with expiration date (Visa, Master Card, American Express or Discover Card) ATM card Employee ID card Voter registration card or letter Student ID card

Social Security cards are not accepted All forms of ID MUST be original and MUST have a signature. If there is a discrepancy caused by a recent name change, a copy of the marriage license/certificate or divorce decree will NOT be accepted at the test center and you WILL NOT BE PERMITTED TO TAKE THE EXAMINATION refer to name change procedures on page 12.

Will I be thumb-printed or photographed at the testing center?

Prometric employs biometric-enabled check-in services at all its test sites. This procedure consists of a number of steps to verify your eligibility to test, including taking an electronic record of your ID, photo imaging, and a digital fingertip record. You are required to undergo fingertip analysis any time you leave and re-enter the testing room for validation purposes. There is video surveillance in all candidate accessible areas of the testing center.

What items are prohibited while taking the examination?

You are not allowed to bring ANY electronic device (cell phones, personal digital assistants (PDAs), cameras, or digital watches) or any hard copy documentation into the testing facility. This includes but is not limited to the lobby, bathroom, test administration check-in and/or waiting rooms or the test administration room. If you are found using such a device during any part of the test administration process, the Testing Center Administrator (TCA) will require you to step out of the test administration area. The TCA will inform you that you have violated test center rules and a report will be filed. The TCA will file a detailed Candidate Proctor Report (CPR) with NBCOT, including the make/model of the prohibited item (if applicable). You will be dismissed and the exam terminated. Your future exam eligibility status will be determined by NBCOT. Page 18 www.nbcot.org

Can I use earplugs?

Candidates may provide their own earplugs as long as they are not connected with a string or wires. Earplugs are subject to inspection by the TCA. Headphones are available at all Prometric Testing Center locations.

What clothing am I allowed/not allowed to bring into testing room?

If you wish to wear a sweater or jacket, the clothing item MUST be donned before entering the testing room. Once in the testing room, you will not be allowed to put on or take off a sweater, jacket, or shoes, or pull a jacket hood up over your head. 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 prior to you being admitted into the testing room and MUST remain in full view at all times. If you need to reposition or take off the head covering or religious item, you will be asked to step out of the testing room into the waiting area.

Do I have to request a special testing accommodation to bring a hearing aid, cochlear implant or insulin pump into the testing room?
If the device makes any kind of noise, the candidate must request and be approved for special testing accommodations in advance. If the device does not make any noise, no testing accommodation is required. All devices will be visually inspected prior to the candidate being admitted into the testing room. If the device needs to be readjusted after the exam has begun, the candidate will be asked to step into the waiting area.

How much time will I have for the examination?

The appointment time for the OTR examination is 5 hours and 15 minutes. The exam itself is only 4 hours long. The extra appointment time is to allow candidates to complete administrative, tutorial, survey information.

Will there be other candidates testing at my test center?

It is likely that there will be other candidates taking different examinations 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 examination?

Yes, you may take breaks during the examination. 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 exam candidates to complete check-in procedures.

Is computer knowledge necessary?

No. The optional tutorial(s) that accompany the examinations walk you through the process of selecting answers and progressing through the examination on the computer. Tutorial time does not count towards your allotted examination time. You can repeat the tutorial(s) if you wish.

Can I Make Notes During the Exam?

You can request to use a wet marker board from the TCA during your examination. If you require additional materials, you will need to wait for the TCA to clean the originally issued wet marker board before reusing.

Can I eat/drink in the testing room?

No; however, beverages and snacks can be stored in lockers located in the testing center waiting area. Candidates may eat or drink in the waiting area only. Page 19 www.nbcot.org

What can I do if the computer malfunctions while taking the exam?

You MUST alert the TCA immediately. Staff will make every effort to remedy the situation as soon as possible. The time spent to remedy the problem will not count as part of your examination time. Due to the nature of the exam delivery system, no previously entered examination data can be lost. If the problem cannot be remedied within 30 minutes, you have the right to reschedule the examination for another day within your eligibility period.

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, approved accommodations not being available, excessive noise or physical disruption within the testing center, or test not available at scheduled time. You MUST file a complaint immediately with the TCA or before leaving the test center and you MUST request a ticket number. You MUST ALSO contact NBCOT by e-mail within 24 hours after the incident occurred and provide NBCOT with the ticket number and case summary. Administrative or technical complaints MUST be e-mailed to credentialingservices@nbcot.org. NBCOT will confirm receipt of the complaint.

Important Note:
Examination challenges of any kind may result in the delay of the examination score being released and the pass/fail status being posted to the NBCOT web site. All exam scores are held until the examination challenge has been fully investigated and resolved.

What is my obligation to maintain confidentiality after I take the exam?

The NBCOTs certification examinations and the items contained therein are protected by federal copyright law. No part of an examination 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 (e.g., Facebook, Twitter, cell phone, blogs, discussion forums). Posting examination or study tool questions to social media or other networking sites constitutes a test security and copyright violation as noted in Principle 1 of the NBCOT Candidate/Certificant Code of Conduct. Infringements of the NBCOT Code of Conduct are investigated by the NBCOTs Qualifications and Compliance Review Committee (QCRC) to determine appropriate disciplinary action.

Important Notes:
NBCOT cannot address administrative or technical complaints with Prometric if you did not first file a complaint at the test center. Administrative or technical complaints submitted after the candidates pass/fail status is posted will not be acknowledged. Appeal of an administrative or technical complaint can only be filed AFTER an administrative or technical complaint has: 1) been submitted by the candidate 2) been reviewed by NBCOT, and 3) had a decision rendered.

What to Bring to the Exam:

Two forms of identification:

First and last names on IDs MUST match name on ATT letter

One must be government-issued photo ID with signature Signatures on BOTH ID documents must be CLEAR
Page 20

www.nbcot.org

After the Exam: Questions & Answers

How are the exams scored?
Each administration of the NBCOT certification examinations is designed to fairly assess the knowledge required for entry-level practice. The total raw score (the total number of correct responses) is converted to a scaled score ranging from 300 to 600 points. To ensure scores on different forms of the examination have the same meaning, raw scores are converted to scaled scores representing equivalent levels of achievement regardless of the form of examination taken. The NBCOT minimum passing scaled score is 450. For more information on scoring, please refer to the Foundations of the NBCOT Certification Examinations, which can be accessed at www.nbcot.org > Publications > Foundations of the NBCOT Certification Examinations.

How will I get my examination result?

After the administration of the examination, your examination will be scored by NBCOT. You should refer to the NBCOT scoring calendar for the exam scoring schedule and dates. The scoring calendar can be accessed at

www.nbcot.org > Certification Candidates > Scoring Information > Exam Scoring Calendar.
You can view your unofficial pass/fail status through your online account after the exam has been scored usually within two to three days after the scoring date.

Important Note: You will get an error message if you attempt to view your results before the exams have
been scored and the results uploaded.

The official score report is mailed within four (4) weeks of taking the examination. If you do not receive your score report within four to six (4-6) weeks of taking the examination you should submit a Duplicate Score Report Request. Duplicate score reports are provided at no cost if submitted within 4-6 weeks after taking the exam. Beyond six (6) weeks, the Duplicate Score Report Request Form MUST be accompanied with the appropriate fee. The form can be accessed at:

www.nbcot.org > Forms > NBCOT Certification Examination Forms > North America > Duplicate Certificate Request Form.

Important Notes:
Telephone requests for duplicate score reports are not accepted Score information and certification numbers will not be released to anyone via telephone, fax, or e-mail. No candidates score identified by name is released to any party without the candidates prior written permission

www.nbcot.org

Page 21

Passing Candidates will receive by mail a congratulatory letter that includes the total scaled score on the examination, an official NBCOT certificate and wallet card, and the Credentials Essentials Toolkit.

SAM

PLE

Upon receipt of the score report, candidates who hold a stateissued limited or temporary permit(s) or license(s) which 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.

Failing candidates will receive a score report that includes the total scaled score, along with performance information for each domain area of the examination. The information on the domain areas is provided for diagnostic purposes only. The score report will include information about how to register to retake the examination (see retaking the examination section on page 23 for more details).

Can I Appeal My Examination Result?

Yes, you may appeal your examination result; however, failing the examination alone is not sufficient grounds for an appeal. The appeal MUST be submitted in writing to NBCOT and MUST specifically state the reason(s) for the appeal, and why the appeal should be granted. Appeal letters should be sent to NBCOT by traceable mail signature of receipt required to: NBCOT Managing Director, Competency Assessment 12 South Summit Avenue, Ste 100 Gaithersburg, MD 20877 The appeal letter MUST be received by NBCOT within 14 days of receipt of the online examination pass/fail results. Correspondence received after this date will not be accepted. NBCOT will provide a response to the candidate regarding the outcome of the appeal within 21 days of receipt of the appeal letter.

Important Note:
Upon receipt of the score report, candidates who hold a state-issued limited or temporary permit(s) or license(s) which 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.

Page 22

www.nbcot.org

Retaking The Examination

Any candidate who fails the examination may apply for another examination administration. The re-application process is the same as the initial application process. Detailed instructions can be found in the candidates score report. When re-applying, the following should be noted: There is a 45-day waiting period after the last examination date before the candidate may test again. The candidate MUST submit a new application in order to re-test. Instructions will be provided in the candidates score report. If the candidate has had a name change since the last exam administration, the candidate MUST follow the instructions on page 12, Name Change (Retake Candidates), before submitting an application for the certification examination. Failure to do so could result in an administrative fee to correct a name on the Authorization to Test (ATT) letter. If re-applying online, the candidate should log onto their online account, using the e-mail address and password selected during initial account set up. A new account should not be created. A fee will be assessed for duplicate accounts. After logging on, click the Re-Apply button.

Important Note:
The candidate MUST wait 15 business days after the previous test date to gain access to the Re-Apply button. This button will only appear on the candidates account if the candidate is eligible to re-apply at that time.

A new application fee will be assessed. New fees will also be assessed for score reporting, confirmation notices, or any other services.

After eligibility has been approved, the candidate will receive a new ATT Letter, with a new 90-day testing eligibility period.

www.nbcot.org

Page 23

NBCOT Certification Renewal: Keep Your Credential Active!

Upon initial NBCOT certification, the credential is valid for a period of three (3) years. Certification renewal is required to maintain active certification. The requirements for certification renewal are: a completed Certification Renewal Application the appropriate renewal application fee accrual of required Professional Development Units (PDU): certificants accrue 36 PDU in the three (3) years between their initial certification date and the renewal due date abidance by the NBCOT Candidate/Certificant Code of Conduct Fulfilling the certification renewal requirements entitles a certificant to continue using the OTR credential.

Why Renew ?
One of the best values of certification renewal is the continued use of the NBCOT credential. The OTR credential is 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. In a recent NBCOT survey(1), certificants identified the top reasons for maintaining certification as recognition of:

Value (2)
Accountablity Professional Commitment Credibility Practice Standard Attainment Professional Growth Accomplishment Specialized Knowledge

OTR Response
92% 92% 91% 90% 86% 81% 85%

(1) Permission was granted from the Certification Board of Perioperative Nursing for NBCOT to use the Perceived Value of Certification Tool (PVCT). (2) Values reflect the essence of the value statements appearing on the PVCT.

How to Renew Certification

There are two ways to renew certification: 1. Submit an online application at www.nbcot.org 2. Complete and mail in a hardcopy application Prior to a certificants renewal due date, NBCOT sends a courtesy reminder notification and renewal instructions. For this reason, it is essential that the certificant maintain their current contact information with NBCOT, including e-mail address. Upon renewal, all certificants receive an updated certificate and wallet identification card.
Page 24

www.nbcot.org

Summary of Exam Candidate Requests

Service Request
Name change before ATT letter is issued (first-time candidate) Name change after ATT letter is issued (first-time candidate)

Service Requirements
Complete Name Change Request Form and submit with copies of government issued IDs reflecting your name change, i.e., drivers license, state issued ID or passport. Complete Reactivation/Reissue of Authorization To Test (ATT) Letter Form, with fee, and copies of government issued IDs reflecting your name change, i.e., drivers license, state issued ID or passport. Must contact NBCOT by telephone or e-mail for instructions prior to submitting online exam application; if candidate applies online prior to contacting NBCOT, administrative fee is assessed to correct online application. There is a 45-day waiting period after the last examination date before the candidate may test again. New address changes can only be made to application before the ATT letter is generated. New address must be updated on exam application. Once ATT letter is issued, the next opportunity to change address will be at Prometric Test Center on day of exam. Address changes may also be made if/when an ATT letter is reactivated/reissued. Online candidates must provide a valid (working) e-mail address that is capable of receiving e-mail from NBCOT. It is candidates responsibility to keep e-mail address current with NBCOT. Candidates can update their e-mail address by contacting NBCOT customer service via e-mail at onlineexamapp@nbcot.org. ATT letter is active for 90 days. If candidate does not take exam within the 90 day period, the ATT letter can be reactivated for additional 90 days. An additional fee is required. Reactivation of ATT letter may be requested online, by logging onto the candidates account, or by submitting the appropriate form available on the NBCOT website. Request when submitting exam application. A fee for each state is required. Complete Official Score Transfer Request Form (available at www.nbcot. org). A fee for each state is required. Increased fee after exam application has been submitted. Request when submitting exam application. A fee for each state is required.

Page Reference
12

12

Name change (retake candidate)

12

Retake examination candidates

23

Mailing address change

13

E-mail address change

Reactivation of ATT letter

12

Exam score report request to state regulatory boards (prior to exam application being approved) Exam score report request to state regulatory boards (after the exam application has been approved) Confirmation of Exam Registration and Eligibility to Examine Notice Request (prior to submitting exam application) Confirmation of Exam Registration and Eligibility to Examine Notice Request (after submitting exam application) If an exam candidate has been charged with and/or convicted of a felony at any time before or after issuance of an Authorization To Test (ATT) letter

8-9

8-9

8-9

Complete Confirmation of Exam Registration and Eligibility to Examine Notice Request Form (available at www.nbcot.org). A fee for each state is required. Based on Candidate/Certificant Code of Conduct (candidate must agree to when signing exam application attestation statement), candidate must notify NBCOT of felony charge and/or conviction. If candidate fails to inform NBCOT, disciplinary action may result.

8-9

www.nbcot.org

Page 25

Appendix

Contents
Examination Application Procedures Checklist ................. A 2013 Certification Examination Application ...................... B

Page 26

www.nbcot.org

Examination Application Procedures Checklist

Completing the NBCOT Examination Application and Submitting Fees:
I have read the NBCOT Certification Examination Handbook for internationally educated candidates. My occupational therapist eligibility determination (OTED) application is complete, and I have been

approved by NBCOT to submit an examination application.

If applying online for the first time, I have set up a new account with my valid/working e-mail address

(username) and password. If I have an existing online application account, I have logged on with my username and password and then I have clicked on the Re-Apply button. to exam application).

If applying with a paper application, I have submitted payment by mail to the NBCOT lockbox address (refer If I want NBCOT to send an Official Score Transfer or Confirmation of Examination Registration and

Eligibility to Examine Notice to a regulatory entity or employer, I have indicated so on my application. the application. If submitting a paper application, I have made a copy for my records.

If applying online, I have printed out the receipt/invoice for my records as proof of successfully submitting I have paid all applicable fees. If I have had a name change at any time prior to taking the certification examination, I have sent to NBCOT

a Name/Address Change Request, the appropriate legal documentation, and fee if applicable.

Option to take the Spanish OTR Exam If I wish to take the Spanish OTR exam, I have completed the following:
Indicated my intent to take the Spanish OTR exam on the exam application. Submitted the exam application and payment to NBCOT.

Scheduling with Prometric

I have contacted the Prometric Call Center to schedule my appointment. Note: An examination date cannot

be scheduled without an ATT Letter. cancellation policy.

If I need to cancel/reschedule my examination date, I will follow the procedures outlined in the

www.nbcot.org

Appendix A

2013 Certification Examination Application OTR and COTA

ID 33 rev120612

Section 1: Applicant Information

I am a graduate from a program: within the U.S. or its territories outside the U.S. I am a: first-time applicant repeating test-taker Date of Birth: First Name: Middle Name: Last Name: Mailing Address: City: State/Province: Postal Code: Country: Phone: home work mobile Phone: home work mobile
If no SSN, skip to next line and provide Student ID#.

Social Security Number:

Student ID Number:
This is the number assigned by school for U.S. graduates; assigned by NBCOT for OTED approvals (including internationally-educated).

E-mail Address (must be active): Choose a Password:

This password can be used to check your application status online.

Section 2: General Information (optional)

Gender: Male Female Multi-racial Native Hawaiian or Other Pacific Islander White 30-39 40 or above

American Indian or Alaskan Native Asian Ethnicity: Black or African American Hispanic/Latino of any race Age: under 21 21-25 26-29

Appendix B

www.nbcot.org

Name:

Section 3: Credential Information

Exam Level: CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA r OCCUPATIONAL THERAPIST REGISTERED OTR U.S. School Name*: U.S. School Code*: Graduation Date (mm/yyyy):

*available online at www.nbcot.org/pdf/US-School-Codes.pdf Exam Eligibility Pathway: OTR Credential: r Entry-Level Masters Degree Entry-Level Doctoral Degree OTED (including internationally educated) Associate Degree Certificate

COTA Credential:

Educational Program Director Requests In the event that my education program director requests my certification examination score, I hereby grant permission to release my score. Please check one: Yes, I grant permission to release my score to my education program director upon their request. No, I prefer not to release my score.

Section 4: Character Questions

HAVE YOU EVER... been charged with or convicted of a felony? (NOTE: Certificants must answer affirmatively if records, charges, or convictions have been pardoned, expunged, released or sealed.) had any professional license, registration, or certification denied, revoked, suspended, or subject to probationary conditions by a regulatory authority or certification board? 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? been suspended and/or expelled from a college or university? Yes No Yes No Yes No Yes No

If you answer yes to any of the character questions, please refer to page 7 of the handbook for further detail regarding documentation requirements. All documentation must be submitted to and reviewed by NBCOT before the examination application will be approved. Mail documentation to: NBCOT, Inc.; Attn: Qualifications and Compliance Review 12 South Summit Avenue, Suite 100 Gaithersburg, MD 20877 www.nbcot.org
Appendix B

Name:

Section 5: Application Acknowledgement and Attestation Statement

By submitting this exam application, you are attesting to having read and understood the following NBCOT Certificant Attestation Statement and the information provided in the NBCOT Certification Examination Handbook. Please read this statement carefully. I have read, understand, and agree to adhere to the provisions of the current edition of the NBCOT Certification Examination Handbook, the NBCOT Candidate/Certificant Code of Conduct (hereinafter referred to as the Code of Conduct), and the NBCOT Procedures for Enforcement of the NBCOT Code of Conduct (hereinafter referred to as the Procedures), all of which can be found on the NBCOT website at www.nbcot.org. By signing below, I am attesting that I have personally completed the exam application and that the information I submit in the application myself and in any required accompanying or subsequent documentation is true and accurate to the best of my knowledge. Additionally, I understand that persons who apply for certification as an OCCUPATIONAL THERAPIST REGISTERED OTR or CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA or persons who have been certified by NBCOT, are subject to the Code of Conduct and the Procedures. I understand that from time-to-time NBCOT may amend its requirements, policies, and procedures for initial certification, certification renewal, and Procedures for Enforcement of the Code of Conduct. During my three-year certification cycle, I agree to notify NBCOT in writing of any violation of the Code of Conduct (e.g. felony charge and/or conviction, suspension, or revocation of a license to practice occupational therapy). I agree to hold NBCOT, its directors, officers, employees, and agents free from any damage or complaint by reason of any action taken in connection with the score or score given with respect to this or any other NBCOT certification examination, or the failure of NBCOT to issue me certification. I understand that if it is confirmed I was not eligible at the time I examined, my examination score will be voided. If it is ever determined that I was a participant in any testing irregularity, such as use of any electronic device during the examination and/or break, or cheating, to include discussing, transmitting or copying a test item(s) or answer(s) to a third-party, before, during or after the examination, my certification or eligibility status with NBCOT may be changed. Further, I understand that if I need to file an examination administrative or technical complaint that I must file such a complaint on-site at the Prometric Test Center, and must request a ticket number. I also agree to notify NBCOT in writing of any address and/or name change within thirty days (30) after the change becomes effective. If requested to do so, NBCOT may verify my certification status. I hereby consent to NBCOTs release of any information regarding this application, my examination eligibility, my examination administration, or my certification status to any academic institution, employer, regulatory agency, or other party that may inquire in writing. I understand that NBCOT reports aggregate school performance data to all occupational therapy education programs and to the Accreditation Council for Occupational Therapy Education, (ACOTE) on an annual basis. Signature: Date: Please print name here:

Section 6: Special Testing Accommodations - For Testing in the U.S. Only

I am requesting Special Testing Accommodations for the certification examination, due to a documented disability. Please submit a completed Special Testing Accommodations Application with supporting documentation to NBCOT. The handbook and application can be found online at www.nbcot.org. I am reapplying for the certification examination, and am requesting identical accommodations previously approved by NBCOT. If you were approved to take the exam with accommodations prior to 2010, you may be required to submit updated documents. I am reapplying for the certification examination, and am requesting different or additional accommodations. Please submit a completed Special Testing Accommodations Application with supporting documentation to NBCOT. The handbook and application can be found online at www.nbcot.org.
Appendix B

www.nbcot.org

Name:

Section 7: Option to Take the Spanish OTR or COTA Certification Examination

Candidates may choose to take the OTR or COTA examinations written in American Spanish. If you wish to take the certification examination in American Spanish examination you MUST check one of the following: I wish to take the OTR examination written in American Spanish I wish to take the COTA examination written in American Spanish

Section 8: Confirmation of Examination Registration and Eligibility to Examine Notice

Please send a Confirmation of Examination Registration and Eligibility to Examine Notice to the following third parties. I have included the $45 fee for EACH notice requested. Please Note: When a confirmation notice is requested for a third party, the candidate will receive a copy at no extra charge. Fees for confirmation notices are non-refundable.

To State Regulatory Boards:

Please Note: ONLY the states listed below accept confirmation notices. Alaska Arizona Arkansas California Delaware District of Columbia Florida Georgia Idaho Illinois Indiana Kentucky Maine Maryland Massachusetts Missouri Montana Nebraska Nevada New Jersey New Mexico New York North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Dakota Tennessee Texas Utah Vermont Virginia West Virginia Wyoming

To Employers and Other Third Parties:

Attn: Company Name: Address: City: State: Postal Code/Zip:

Section 9: Official Score Transfer

Please send an Official Score Transfer to the jurisdiction(s) selected below. I have included the $40 fee for EACH score report. Please Note: No state will receive a report unless it is marked here and the additional payment for EACH state marked is enclosed. Fees for score reports are non-refundable. ONLY the states listed below accept score reports. Alabama North Dakota Utah Idaho Minnesota Illinois Mississippi Alaska Ohio Vermont Arizona Oklahoma Virginia Indiana Missouri Arkansas Iowa Montana Oregon Washington California Kansas Nebraska Pennsylvania West Virginia Colorado Kentucky Nevada Puerto Rico Wisconsin Connecticut Louisiana New Hampshire Rhode Island Wyoming Delaware Maine New Jersey South Carolina District of Columbia Maryland New Mexico South Dakota New York Tennessee Florida Massachusetts Georgia Michigan North Carolina Texas www.nbcot.org Appendix B

Name:

Section 10: Fees and Payment for Paper Applicants

Examination Application/Study Tools NBCOT offers a number of study tools to assist candidates with their exam preparation including online tools, practice tests, and study guides. Visit www.nbcot.org > Study Tools Central for more information. Service Fees: Examination Application Fee Official Score Transfer Request Confirmation of Examination Registration and Eligibility Notice Returned Check Fee $500 (online application) $540 (paper application) $40 per score report $45 per notice $35
Online Application Fee Paper Application Fee Official Score Transfer Confirmation Notice
Each Qty. Amount

$500 $540 $40 $45

x x x x

= = = =

Total Payment =

NBCOT Application Payment

Name: Street Address: Credit Card Number: Expiration Date: Credit Card Holders Name: City: State/Province: Postal Code: Country: Phone: E-mail: Payment: Check Money Order Visa MasterCard
Please make checks and money orders payable to NBCOT. Checks must be drawn on a U.S. bank. I authorize the amount indicated above to be charged to my credit card.

3-digit CVV code:

Card Holders Address (required):

Signature of Cardholder (required)

Mail completed application, signed attestation, any required documentation and payment together in one envelope, to:

NBCOT, Inc. P.O. Box 64971 Baltimore, MD 21264

www.nbcot.org

Appendix B

2013 National Board for Certification in Occupational Therapy, Inc. NBCOT (formerly American Occupational Therapy Certification Board AOTCB) is a service and trademark of the National Board for Certification in Occupational Therapy, Inc. OTR is a certification mark of the National Board for Certification in Occupational Therapy, Inc. COTA is a certification mark of the National Board for Certification in Occupational Therapy, Inc. All marks are registered in the United States of America.

12 S. Summit Avenue, Suite 100 Gaithersburg, MD 20877 www.nbcot.org