NBCOT Application 2026: Steps, Transcripts and the ATT Letter

Who is eligible for the NBCOT exam?

For the Occupational Therapist Registered (OTR) exam: an entry-level degree from an occupational therapy (OT) program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE).
For the Certified Occupational Therapy Assistant (COTA) exam: an entry-level degree from an ACOTE-accredited occupational therapy assistant (OTA) program.
If your entry-level OT degree isn’t from a US-accredited school: approval through NBCOT’s Occupational Therapist Eligibility Determination (OTED) process first. OTED approval lasts seven years, and you must pass the OTR exam within them.
Everyone: agreeing to NBCOT’s Code of Conduct and passing its character review.

ACOTE accredits doctoral and master’s OT programs and baccalaureate and associate OTA programs, all under its 2023 Standards, which programs had to meet by July 31, 2025. If NBCOT changes its eligibility rules, you have three years from your graduation date to test under the old ones.

How do you fill in the NBCOT application?

Read the Certification Exam Handbook in full. NBCOT makes this a required step.
Log in to MyNBCOT, or create an account if you’ve never had one, and click Start My OTR/COTA Exam Application.
Check your profile. Give a street address, not a P.O. box, or the background check can’t be verified.
Confirm your academic details and answer the character questions honestly.
Say whether you need testing accommodations, and upload at least one supporting document if you do.
Add services: one score transfer and one eligibility confirmation notice are free if you add them now.
Choose whether a failing feedback report goes to your program director, agree to the attestation, and pay.

You must fill in the application yourself. One completed by a family member, recruiter or professor isn’t valid, and NBCOT bars that candidate for three months and keeps the fees. You can save and come back, and you can still change it while it shows “New.” The fees are on the cost page.

NBCOT exam cost →NBCOT login and your MyNBCOT account →

Transcripts and the Degree Verification Form

Ask for your official final transcript after you’ve applied. Documents that arrive before you have an account are destroyed after 30 days, and sending them before you apply slows your application.
The transcript must show your degree as awarded, with its title and date, the major (occupational therapy or occupational therapy assistant), every course for the degree and the registrar’s seal, stamp or signature.
It must come through a secure transcript service to transcripts@nbcot.org, or by USPS straight from your registrar to NBCOT, One Bank Street, Suite 300, Gaithersburg, MD 20878. Unofficial copies, photocopies and emails from the registrar aren’t accepted.
A DVF lets you test before your school issues the transcript, if you’ve met every degree requirement. It must be used within six months of graduation and in the same calendar year, and your program director approves it first.
With a DVF, NBCOT holds your result until it has approved your final transcript.

Character review and background check

Every first-time applicant answers eight character questions, about felony charges or convictions, discipline against a professional license or certification, findings of negligence or misconduct that harmed someone, and suspension or expulsion from a college. NBCOT also runs a background check through a third-party company.

A “yes” doesn’t automatically mean you’re refused. You send a written explanation, plus court papers if you’ve been on parole or probation in the last seven years, and NBCOT reviews each case. If you’re worried before you even start school, NBCOT offers an Early Determination Review.

Testing accommodations

NBCOT provides reasonable accommodations under the Americans with Disabilities Act (ADA). You request them inside the exam application, with documentation from a qualified healthcare professional, and NBCOT does its first review within 10 business days. Items on Pearson’s Comfort Aid List, such as some medical devices, don’t need a request.

NBCOT lists English as a second language and test anxiety without a diagnosed disability as examples that don’t meet the ADA definition. A one-time accommodation is possible for some temporary conditions, and nursing candidates can ask for 60 minutes of stop-the-clock break time to pump. Questions go to accommodations@nbcot.org.

Your ATT letter and what comes next

NBCOT emails your ATT letter, from donotreply@nbcot.org, within three business days of approving your application. It’s active for 90 days, and you must test inside its dates. If you need longer, you can reissue it for another 90 days while your application is still active.

To withdraw, email info@nbcot.org with a short reason before the application expires. You may get a partial refund, and you can apply again three months after you withdraw.

NBCOT testing locations and booking →NBCOT scoring dates →

Sources: NBCOT · ACOTE and 8 more. Checked October 2026.