NBCOT Exam Registration: How to Apply, Pay, and Schedule

NBCOT exam registration happens in two stages: first you apply and pay in your MyNBCOT account; then, once NBCOT approves you and issues your Authorization to Test (ATT) letter, you book a seat with Pearson VUE. The application and scheduling steps are the same for the OTR and COTA exams.

Your 7-step NBCOT registration checklist

☐ 1. Confirm your route.

• OTR (Occupational Therapist Registered) exam: you need an entry-level degree from an occupational therapy program accredited by ACOTE (the Accreditation Council for Occupational Therapy Education).
• COTA (Certified Occupational Therapy Assistant) exam: you need the same from an ACOTE-accredited occupational therapy assistant program.
• Before you apply: NBCOT's checklist says to wait until you're cleared for graduation (or already have the degree) and have finished required fieldwork.
• Internationally educated OTs: if you didn't earn your entry-level master's or doctoral OT degree from a U.S.-accredited college or university, you go through NBCOT's Occupational Therapist Eligibility Determination (OTED) review first ($850). This checklist starts after OTED approval.
• Everyone: you agree to NBCOT's Code of Conduct and complete the required character review. First-time applicants and reapplicants with a new affirmative answer undergo a background check.

☐ 2. Read the Certification Exam Handbook. NBCOT lists this as a required step. Here's the official handbook (PDF).

☐ 3. Open your MyNBCOT account (only one).

• If you don't already have an account, go to nbcot.org/login, select Create Account, then choose "I have never been OTR or COTA certified."
• Confirm your email; check your spam folder for the message.
• A duplicate account costs $35. If your SSN prevents you from creating an account, you may already have one. Use Forgot Password? or call NBCOT at 301-990-7979 (9 a.m.–5 p.m. ET) instead of creating another.
• COTA moving up to the OTR? Log in to your existing account and add your OT degree to your profile before applying.

☐ 4. Complete the application and pay $540 for a first online attempt. Log in and select Start My OTR/COTA Exam Application. You fill it out yourself. Applications completed or submitted by anyone else (family, recruiters, program directors) are invalid, and NBCOT keeps the fees and makes you ineligible for three months. Along the way:

• Profile: give a street address, not a P.O. box, or the background check can't be verified.
• Character questions: answer honestly. A "yes" needs documentation (details below).
• Testing accommodations: select yes or no. If yes, upload your supporting documents here, inside the application (details below).
• Services: if you need them, add your one free Score Transfer and one free Eligibility Confirmation Notice before paying. After payment, each costs $35. Which ones you need.
• Program preferences: you can choose whether your program director receives your feedback report if you don't pass. Opting in is optional.
• Payment: the fee is due now, at application. You won't pick a test date until your ATT arrives.

The application is valid for 90 days from submission, so apply when you expect to test within that window. You can Save and Quit and finish later. NBCOT warns that your browser's back button can break the application, so use the application's own Back and Continue buttons.

☐ 5. Get your school document to NBCOT. NBCOT doesn't request it from your school. You arrange it, after applying. If NBCOT has already approved your OTED application, you don't submit another transcript. Retakers don't resend a transcript unless NBCOT asks. For the standard U.S.-educated first-attempt route:

• Official final transcript (most graduates). It comes from your school's secure transcript service to transcripts@nbcot.org, or by USPS mail from the registrar.
• Degree Verification Form (DVF), if you've finished every requirement but your school hasn't issued the final transcript (transcript or DVF?).

NBCOT reviews transcripts in the order received. Review can take up to 10 business days, longer in busy seasons. MyNBCOT shows whether your transcript has arrived.

☐ 6. Watch for your ATT letter. Once everything is approved, your ATT arrives within 3 business days in MyNBCOT and by email from donotreply@nbcot.org. That means payment, academic document, any required background check, and any requested accommodations. Check your spam folder.

• The ATT is active for 90 days.
• You must take the exam within the dates printed on the letter. Booking within them isn't enough.

☐ 7. Book with Pearson VUE. In MyNBCOT, select Schedule My Appointment to reach your Pearson dashboard.

• Book at least one day ahead; same-day appointments aren't offered.
• Choose your date with the scoring calendar in mind.
• To move or cancel later, use Manage My Appointment at least 48 hours before your appointment.

You can look up test-center locations anytime on Pearson's NBCOT page, but you can't book without an ATT. Pearson now calls itself Pearson Professional Assessments (formerly Pearson VUE).

Testing before the end of 2026? NBCOT guarantees an ATT before its holiday closure only if your application is complete, including receipt of payment and your official final transcript or Degree Verification Form, by Thursday, December 17, 2026. That deadline does not reserve a seat. The last day to test in 2026 is December 19. See the year-end dates.

Sources: Certification Exam Handbook pp. 10–19, 33, 36; apply for your exam; schedule your exam; character review.

Where are you now? Your next step

Use this table if you've already started.

For application questions, contact NBCOT at info@nbcot.org or 301-990-7979. For appointment problems after booking, use the contact route on your ATT or Pearson's NBCOT page.

NBCOT exam fees

All amounts are in U.S. dollars.

When the $115 reissue fee applies:

• You attempt to cancel or reschedule less than 48 hours before your appointment.
• You don't show up.
• You arrive more than 15 minutes late and can't test.
• You arrive without proper ID and can't test.

If you miss the appointment or attempt to cancel or reschedule inside 48 hours, request the new ATT after the appointment date has passed.

Reissuing to push your test window later, after a name change, or after an on-time cancellation isn't in that group.

One more trap on exam day: you get 7 minutes to accept the acknowledgment screen. Miss it, and the appointment is forfeited and you pay to reissue your ATT.

These are NBCOT's fees only. Your school's transcript fee, travel, and your state license application are separate.

Sources: NBCOT fees; handbook pp. 12, 18–19, 21, 28.

How long NBCOT registration takes

NBCOT publishes timing for individual steps, not a total turnaround. Don't add these up as a promise.

Fastest path:

• Apply once you're cleared to graduate, done with required fieldwork, and planning to test within 90 days.
• Add any needed free services before you pay.
• If NBCOT needs your transcript, have the registrar send it right after you submit.
• If you need accommodations, have your documentation ready before you open the application.

Sources: handbook pp. 11, 15, 18, 33, 36; apply page; Testing Accommodations Handbook p. 11.

Transcript or DVF?

This table covers the standard U.S.-educated first-attempt route.

Your official final transcript must show all 8 of these

1. Your full name
2. Your SSN or student ID number
3. The school awarding the occupational therapy degree
4. Every course required for the ACOTE-accredited entry-level degree
5. The major: "occupational therapy" or "occupational therapy assistant"
6. The title of the degree
7. The date the degree was awarded
8. The registrar's seal, stamp, or signature

How to send it:

• Electronically: through a secure, verifiable transcript service or clearinghouse to transcripts@nbcot.org. NBCOT won't accept a transcript emailed directly by your registrar's office.
• By mail: USPS only, from the registrar, in an envelope with the registrar's return address, or marked with a registrar's stamp, initials, or "Transcripts Enclosed" on the back flap. Address it to NBCOT, Inc., One Bank Street, Suite 300, Gaithersburg, MD 20878.

Not accepted:

• unofficial copies
• photocopies
• letters from the school
• transcripts dated before the degree was awarded

Transcripts that arrive before you've created a MyNBCOT account are destroyed after 30 days.

How the DVF works

1. After you apply, request the DVF in MyNBCOT. It goes to your program director.
2. Your program director approves it in NBCOT's portal and sends it to your registrar.
3. Your registrar completes, signs, and seals it, then mails it or emails it to transcripts@nbcot.org.

Military OT and OTA programs have their own timing rules in the DVF policy.

The catch: testing on a DVF holds your pass/fail result until NBCOT approves your official final transcript. If your transcript is approved before your scheduled score date, your result follows that scoring date. If it is approved after that date has passed, your result (and any requested Score Transfer to a state board) goes out within 24–48 business hours. You don't wait for the next score date.

Sources: handbook pp. 15–16; DVF policy (revised 11/17/2025); scoring page.

Pick your test date by score date

NBCOT releases scores on set dates on its scoring calendar, not a fixed number of days after you test. To get your result on a specific score date, test at least three days before it. For example, for a Thursday release, test by the Monday before. NBCOT says there are no exceptions. A DVF transcript hold or an unforeseen scoring delay can still postpone release.

If a job start or temporary permit hinges on a result date:

1. Pick the score date first.
2. Count back three days.
3. Book an exam date on or before that day, inside your ATT dates.

2026 year-end dates

If your ATT window crosses the blackout, those blackout dates aren't usable test days.

Source: NBCOT scoring page, "2026 Year-End Schedule".

Sending your score to a state board

Passing the NBCOT exam gives you national certification. It does not license you to practice. Your state board licenses you, and you apply to it separately. NBCOT offers two services that send proof to a board or employer:

• Score Transfer: sends your score electronically to a state board.
  • A board does not get your score automatically; you have to order the transfer.
  • If ordered before you test, it goes out 2–3 business days after scoring.
  • NBCOT lists every state except Hawaii as accepting Score Transfers.
  • Some states want one for every attempt.
• Eligibility Confirmation Notice: confirms you've applied and are approved to test, which some boards and employers ask for.
  • NBCOT lists these states as not accepting it: Alabama, Arizona, Colorado, Hawaii, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, New Hampshire, North Carolina, South Carolina, Washington, and Wisconsin.

Check your board's requirements before you pay, so your free requests go to the right service and the right state.

• A Score Transfer can't be switched to another state later.
• Ordered services aren't refundable.
• Give NBCOT the same SSN you give your board. If they don't match, the board can't retrieve your score and you'll pay for a new transfer.

NBCOT's state regulatory board contact list (PDF) has every board's website and contact details.

Sources: handbook pp. 16–18; Score Transfer; Eligibility Confirmation Notice; state licensure after the exam.

Testing accommodations

You request accommodations inside the exam application, not beforehand.

1. Read the Testing Accommodations Handbook.
2. Check Pearson's comfort-aid list. Some items, like certain medical devices and medication, don't need a request.
3. Gather your documentation before you apply. NBCOT recommends its Testing Accommodations Request Form, completed by your qualified healthcare professional.
4. In the application, select Yes, answer the questions, and upload everything there. Don't mail or email medical records to NBCOT. If an upload fails, contact accommodations@nbcot.org.

After you apply:

• When you're approved, review the approval notice in MyNBCOT. If you agree, select I accept and save a copy.
• If you disagree with what was approved, contact accommodations@nbcot.org within 7 days of receiving the approval notice to ask for another review.
• Your ATT will say "Testing Accommodations" at the top. Follow the scheduling instructions in both the ATT and the approval notice.
• Some accommodations can't be booked online. In that case, follow the instructions to contact Pearson customer service; Pearson's accommodation scheduling team will then call you within 3 business days.

Earplugs and headphones: Pearson Professional Centers and Pearson VUE Test Centers provide earplugs and noise-reducing headphones without approval. You need an approved accommodation to use them at a Pearson Authorized Test Center Select (PTC Select) site, or to bring your own anywhere.

Need accommodations after your ATT arrives because of an unforeseen medical diagnosis, complication, or temporary condition? Check the handbook and comfort-aid list first. If an accommodation request is needed, cancel any Pearson appointment before editing the Testing Accommodations section of your application.

Source: Testing Accommodations Handbook (ID 62 rev052926) pp. 4–13.

Character review questions

The application asks whether you have ever had, or currently face, any of these:

• a felony guilty plea or conviction, or a pending felony charge
• a professional license, registration, or certification surrendered, denied, revoked, suspended, or put on probation, or one now under disciplinary review
• a finding or pending charge of negligence, malpractice, recklessness, or willful or intentional misconduct that harmed someone
• suspension or expulsion from a college or university, or an active investigation that could lead to one

If you answer yes:

• A "yes" doesn't automatically disqualify you; NBCOT reviews each case individually.
• Upload a detailed written explanation.
• If you were on parole or probation in the past 7 years, also upload proof you complied with or completed the court's terms.
• NBCOT must finish its review before your application can be approved.

Worried before you apply? NBCOT's Early Determination Review ($225) is available to prospective or current OT/OTA students with a "yes" to a past-event character question—1a, 2a, 3a, or 4a in the handbook. It reviews whether that event might affect exam eligibility. You can request it even before starting OT school. A favorable result doesn't change what you do later: you still answer "yes" on the exam application, and you still go through a new background check.

Answered "yes" by mistake? You can change it while your application is still in New status. After that, email professional.conduct@nbcot.org.

Sources: handbook pp. 13–14; character review; Early Determination Review request form.

Changing something after you apply

Once your application expires, NBCOT can't reissue the ATT. If you need a new ATT, submit a new application and pay the full fee again.

Sources: handbook pp. 13, 19–21; reissue ATT; refund policy.

Before exam day: what to have ready

• Two IDs: one primary and one secondary, or two primary.
  • Both must be original, unexpired IDs that meet NBCOT's document-specific requirements, including the signature or barcode requirements for the type of ID you bring.
  • Both must show the same first and last name as your ATT. Middle names don't matter.
  • Primary IDs include a driver's license, passport, state ID, permanent resident card, or military ID.
• Arrive 30 minutes early. The standard exam is 4 hours, but the full appointment runs about 4 hours 45 minutes with check-in and the tutorial.
• Pick your test center on purpose. If you want earplugs or headphones without an accommodation, choose a Pearson Professional Center or Pearson VUE Test Center rather than a PTC Select site.

Source: handbook pp. 26–28.

FAQ

Can I register before I graduate?

Under the standard U.S. route, only once you're cleared for graduation (or have your degree) and have finished required fieldwork. If your degree isn't awarded yet, the DVF route lets you test after you've completed all degree and graduation requirements, with program approval and within the DVF's timing rules. Your result is held until NBCOT approves your final transcript. DVF requirements.

Is the NBCOT exam given by Pearson or Prometric?

Pearson is NBCOT's exclusive test administration partner. Guides that still mention Prometric are out of date. Official Pearson NBCOT page.

Is registration different for the OTR and COTA exams?

The account, application process, and fees are the same; the education requirements differ. The OTR exam has 180 items and the COTA has 190, each with 4 hours of standard exam time. Handbook, pp. 10, 23, 28.

How do I register for a retake?

Submit a new application from your existing MyNBCOT account ($430 online). You don't resend your transcript unless NBCOT asks. Free services don't carry over, so re-add any needed Score Transfer or Eligibility Confirmation Notice before paying.

Waiting periods count from your last test date:

You can reapply 30 days before your next eligible exam date. Your MyNBCOT dashboard shows the date you can reapply. Handbook, pp. 33–34.

Does registering for the NBCOT exam start my state license application?

No. NBCOT certification and state licensure are separate. A Score Transfer only sends your result. You still apply to your state board directly.

Sources

Last verified November 4, 2026. This covers fees, application steps, transcript and DVF rules, accommodations process, ATT and scheduling policy, and the 2026 year-end dates. NBCOT can change fees and policies, so confirm on nbcot.org before you pay.

• NBCOT, Certification Exam Handbook (ID 40 rev092526)
• NBCOT, Testing Accommodations Handbook (ID 62 rev052926)
• NBCOT, Fees
• NBCOT, Eligibility requirements
• NBCOT, Apply for your exam
• NBCOT, Schedule your exam
• NBCOT, Degree Verification Policy
• NBCOT, Scoring and 2026 year-end schedule
• NBCOT, Reissue ATT Letter
• NBCOT, Refund Policy
• NBCOT, Character review
• NBCOT, Early Determination Review and request form (ID 24 rev052726)
• NBCOT, Score Transfer and Eligibility Confirmation Notice
• NBCOT, After the exam
• NBCOT, Occupational Therapy Regulatory Body Contact List by State (PDF)
• Pearson, NBCOT test-taker page
• Pearson, Comfort-aid list
• Pearson, About Pearson and its name change

Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by the National Board for Certification in Occupational Therapy, Inc. (NBCOT) or Pearson. Exam and credential names identify their subjects; trademarks belong to their respective owners. For decisions about your own application, NBCOT and your state board have the final word.

By the Castleport Test Prep Editorial Team