These forms may be completed online, however, they cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form online, you must print the form and mail it to the address below.
Fees (if applicable) are payable to the "Licensure Unit".
Licensure UnitOccupational TherapyPO Box 94986Lincoln, NE 68509-4986
Duplicates/Reissue form Name Change form Occupational Therapist Occupational Therapy Assistant Physical Agent Modalities Certification Temporary Occupational Therapist Assistant License Temporary Occupational Therapist License Physical Agent Modality Course Approval Reinstatement Application
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