Information Update Forms

You are required to update your personal information, employment and supervision information online by going to the personal profile link listed below and following the instructions.   You may also purchase online a duplicate 8 1/2" x 11" License Certificate ($15.00) or a new wallet size renewal card ($5.00).

Please note pursuant to Rule 21 NCAC 38 .0401, "All licensees shall notify the Board in writing of each change of name, residence, trade name, business address or mailing address within ten days of such change" and, pursuant to Rule .0901, “Occupational therapy assistants and supervising occupational therapists must notify the Board office in writing of any change in ceasing or assuming supervision.”

 

Update your personal profile information online by using the button below.

 

Update Online Profile

 

Use the button below to purchase a Duplicate Licenses Certificates or a Wallet Card online.

 

Purchase Duplicate License

 

Information Update forms for download
Description of Download Download Link
Name Change Only Notification Form Download