Nebraska DHHS: Licensing & Regulatory Affairs: Occupational Therapy: Applications

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Occupational Therapy
Applications

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 Unit
Occupational Therapy
PO Box 94986
Lincoln, NE 68509-4986

Duplicates/Reissue form
Name Change form
Occupational Therapist
Occupational Therapy Assistant
Physical Agent Modalities Certification
Temporary Occupational Therapist Assistant Permit
Temporary Occupational Therapist Permit
Physical Agent Modality Course Approval

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Occupational Therapy Applications

Occupational Therapy
Applications