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 detailed instructions.   You may also purchase via 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 My Personal Profile Online Update
Purchase Duplicate License Certificate or Wallet Card Purchase
Name Change Only Notification Form Download

Except for name changes, you may comply with the written and signing requirements of Rules .0401 and .0901 by updating your personal profile online. Name change requests are required to be submitted to the Board office by email, along with a photocopy of proof of your name change, i.e.: marriage license, divorce papers, or court documents relating to legal change of birth name. Please use the Name Change Notification form listed above.