Section Occ 302.04 - Required Documents Applicants for initial licensure as an occupational therapist or occupational therapy assistant shall provide, or arrange for the board to receive, the following documents supporting their applications:
(a) A recent passport size, 2" x 2", original head-shot photograph;(b) On a separate sheet, a detailed report of the relevant circumstances if any of the answers to questions (g)(1) through (g)(6) on part one of the application form is in the affirmative;(c) On a separate sheet, a detailed report of the relevant circumstances if any of the answers to questions (j)(1) through (j)(5) on part 2 of the application form is in the affirmative;(d) Official transcripts showing all post-secondary education: (1) Mailed directly to the board by the issuing institution(s); or(2) Submitted by the applicant in one or more envelope(s) sealed by the institution(s) in such a manner that it would be evident to the board if the envelope(s) had been opened;(e) An official letter of verification sent directly to the board from every state which has issued a license or other authorization to practice stating whether:(1) The license or other authorization is or was, during its period of validity, in good standing; and(2) Whether any disciplinary action was taken against the license or other authorization to practice;(f) If the applicant was ever certified by NBCOT, unless the information is available only on a website through a secure connection, a letter verifying such certification sent by NBCOT directly to the board;(g) If the applicant was not previously certified by NBCOT, unless the information about the applicant's success on the examination required by Occ 303.01(b)(4) is available only on a website through a secure connection, a letter verifying that the applicant passed the examination sent by NBCOT directly to the board;(h) A resume presenting a chronologically organized account of the applicant's experience in occupational therapy since the completion of the academic program, including: (1) Each separate experience in paid or volunteer work as: a. A direct care-giver in occupational therapy;b. An occupational therapy educator;c. An occupational therapy administrator;d. A member of an occupational therapy board or committee; ande. An occupational therapy consultant;(2) The time period of each separate experience described by its beginning and ending dates;(3) The number of hours of engagement in each separate experience estimated on a per-week or per-month basis; and(4) The physical address of each separate experience;(i) If Occ 303.02 is applicable, the following proofs of having met the continuing competence requirements: (1) A transcript of each professional education program taken displaying the hours of continuing professional education credited; or(2) A proof of attendance displaying, for each professional education program: a. The name of the applicant;b. The name of the program, if descriptive of its contents, or other description of the program contents;c. The beginning and ending dates of the program;d. The duration of the program stated in hours; ande. The signature of a representative of the program's provider;(j) If Occ 304.01 is applicable, the completed supervision form described in Occ 304.06; and(k) An original, not a photocopy, of a criminal offender record report: (1) Issued by each state where the applicant has resided or been licensed within the past 6 years, providing that such state will: a. Send the report to the board; orb. To the applicant to be forwarded to the board;(2) Covering the applicant under his or her name and any aliases; and(3) Dated within 6 months preceding the application for licensure.N.H. Admin. Code § Occ 302.04
Amended by Volume XXXIV Number 16, Filed April 17, 2014, Proposed by #10555, Effective 3/26/2014, Expires3/26/2024.Amended by Volume XXXV Number 32, Filed August 13, 2015, Proposed by #10901, Effective 7/29/2015, Expires7/29/2025.