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Serving the public interest by advancing client care and professional practice through evidence-based certification standards and the validation of knowledge essential for effective practice in occupational therapy.


Certified occupational therapy professionals providing effective evidence-based services across all areas of practice worldwide.

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Contact Us

The National Board for Certification in Occupational Therapy, Inc. (NBCOT®)

12 South Summit Avenue
Suite 100
Gaithersburg, MD 20877
(301) 990-7979

Email NBCOT at

Business Hours
Monday-Thursday: 9 am – 5 pm, Lunch: 12 pm – 12:45 pm

Friday: 9 am – 4 pm, Lunch: 12 pm – 1 pm


OTR® & COTA® Credential Verification

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Exam Day - Questions & Answers

Format and Scoring Questions

How much time is allotted for the actual exam?

Candidates are allotted 4 hours to take the examination.  A clock on the screen counts down the testing time for the examination. Several optional tutorials are provided.  These do not count against the exam time.

What is the format of the OTR exam?


  • 170 four- and three-option single response multiple choice items, and
  • Three clinical simulation test (CST) problems.

Refer to the NBCOT Exam Handbook for details about these item types.

What happens if I run out of time during the exam?

Only multiple choice questions that have an option selected are forwarded for scoring. 

Questions "marked for review" BUT NO option selected?

If a multiple choice question is “marked for review” but has no option selected, it will not be scored.

Question "marked for review" WITH AN option selected?

If a multiple choice question remains “marked for review” when the exam time runs out and an option has already been selected, that item will be scored.

Test Center Questions

What are the requirements for admission to the test center?

  • You MUST arrive 30 minutes prior to your scheduled appointment with two forms (two primary forms or one primary and one secondary form) of acceptable identification.
  • The first and last name on both IDs MUST match the first and last name on the ATT letter. 
Acceptable Primary identification is:
  • A currently valid, government-issued photo ID with legal name and legible signature.
Primary ID Requirement   Requirement Requirement  Requirement 
Driver’s License Current issue date Legal name Signature Photograph
Passport Current issue date Legal name Signature Photograph
State-issued Current issue date Legal name Signature Photograph
Permanent Resident/Green Card Current issue date Legal name Signature/barcode Photograph
Military ID Current issue date Legal name Signature/barcode Photograph
Acceptable Secondary identification is:
  • A current major credit card with expiration date (Visa, MasterCard, American Express, or Discover)
  • ATM card
  • Employee ID card
  • Voter registration card or letter
  • Student ID card

Social Security cards are not accepted

  • All forms of ID MUST be original and MUST have a signature that matches the first and last name of the ATT letter. Signing with a nickname is not valid. If there is a discrepancy caused by a recent name change, a copy of the marriage license/certificate or divorce decree will NOT be accepted at the test center and you WILL NOT BE PERMITTED TO TAKE THE EXAMINATION.

Will I be fingerprinted or photographed at the testing center?

Prometric employs biometric-enabled check-in services at all its test sites. This procedure consists of a number of steps to verify your eligibility to test, including taking an electronic record of your ID, photo imaging, and a digital fingertip record. You are required to undergo fingertip analysis any time you leave and re-enter the testing room for validation purposes. There is video surveillance in all candidate-accessible areas of the testing center.

What items are prohibited while taking the examination?

Prohibited items include ANY electronic device (cell phones, personal digital assistants [PDAs], or any type of camera device), any type of watch, any jewelry outside of wedding and engagement rings, or any hard copy documentation. These items are not allowed in any area of the testing facility, including, but not limited to, the lobby, bathroom, test administration check-in and/or waiting rooms, or the test administration room.

Candidates undergo metal detector scanning for prohibited items. Prometric also conducts inspections of any and all eyeglasses, jewelry, and other accessories. You may be asked to remove these items for inspection. Questionable items should not be brought into the test center. Questionable items brought into the test center may need to be placed in your locker. To avoid delays at check-in and upon return from breaks, you may wish to take the necessary steps to leave such items at home or in your car.

If you are found accessing a cell phone, using an electronic device, in possession of any type of camera device, or referencing exam-related material during any part of the test administration process, the Testing Center Administrator (TCA) will require you to step out of the test administration area. The TCA will inform you that you have violated test center rules and a detailed Center Problem Report (CPR) will be filed with NBCOT. You will be dismissed and the exam terminated. Any type of camera device will be confiscated by Prometric. Your future exam eligibility status will be determined by NBCOT.

Can I use earplugs?

You may bring your own earplugs as long as they are not connected with a string or wires. Earplugs are subject to inspection by the TCA. Headphones are available at all Prometric Testing Center locations.

What clothing am I allowed/not allowed to bring into the testing room?

A light sweater or jacket may be worn in the testing room, and may be taken on or off as needed. Heavier jackets or coats are not allowed to be worn in the testing room. Once in the testing room, you will not be allowed to take off your shoes. Head coverings of any kind are not allowed in the testing room unless it is being worn for religious purposes (such as hats, turbans, scarves, and yarmulkes). If the item is worn for religious purposes, it will be visually inspected before you are admitted into the testing room and MUST remain in full view at all times. If you need to reposition or take off the head covering or religious item, you will be asked to step out of the testing room and into the waiting area. All types of hair accessories, ties, and bowties are subject to inspection, and you may be prohibited from wearing them in the testing room. Jewelry outside of wedding and engagement rings is prohibited in the testing room. Please visit Prometric's website here for additional information about Prometric's test center security policies.

Do I have to request a testing accommodation to bring a hearing aid, cochlear implant, or insulin pump into the testing room?

If the device makes any kind of noise, you must request and be approved for testing accommodations in advance. If the device does not make any noise, no testing accommodation is required. All devices will be visually inspected before you are admitted into the testing room. If the device needs to be readjusted after the exam has begun, you will be asked to step into the waiting area. A list of pre-approved personal items that do not require a request for testing accommodations is available at

Why is my appointment time different from my exam time?

The appointment time for the OTR® and COTA® examinations is 5 hours and 15 minutes. The exams themselves are only 4 hours long. The extra appointment time is to allow you to complete administrative, tutorial, and survey information. 

Will there be other candidates testing at my test center?

It is likely that there will be other candidates taking different examinations at your test center during your exam appointment. The layout of the testing cubicles ensures you have ample workspace and privacy from other test takers.

Can I take a break during the examination?

Yes, you may take breaks during the examination. However, the exam clock will continue to run while you are on the break. You will be required to complete all check-in procedures to re-enter the testing room. This may require waiting for other test takers to complete check-in procedures. Please note that you may not exit the test center building while taking a break. Exiting the test center during your exam could result in you being dismissed and the exam terminated. Exam fees could be forfeited and your future exam eligibility status will be determined by NBCOT.

Is computer knowledge necessary?

No. The optional tutorial(s) that accompany the examinations walk you through the process of selecting answers and progressing through the examination on the computer. Tutorial time does not count towards your allotted examination time. You can repeat the tutorial(s) if you wish. You can also view the exam tutorial(s) online in advance at

Can I make notes during the exam?

Note taking is not allowed during the tutorial or at any time before test time starts to count down. You can request to use a wet marker board from the TCA during your examination. If you require additional materials, you will need to wait for the TCA to clean the originally issued wet marker board before reusing.

Can I eat/drink in the testing room?

No. However, beverages and snacks can be stored in lockers located in the testing center waiting area. You may eat or drink in the waiting area only.

What can I do if the computer malfunctions while I am taking the exam?

You MUST alert the TCA immediately. Staff will make every effort to remedy the situation as soon as possible. The time spent to remedy the problem will not count as part of your examination time. Due to the nature of the exam delivery system, no previously entered examination data can be lost. If the problem cannot be remedied within 30 minutes, you have the right to reschedule the examination for another day within your eligibility period.

What is my obligation to maintain confidentiality after I take the exam?

The NBCOT certification exams and the items contained therein are protected by federal copyright law.  No part of an exam may be copied, reproduced, or shared in any manner, in part or whole, by any means whatsoever, including memorization, verbal, written, and/or electronic transmission, which includes, but is not limited to Facebook, Twitter, cell phone, blogs, and discussion forums. Posting exam or study tool questions to social media or other networking sites constitutes a test security and copyright violation as noted in Principle 1 of the NBCOT Candidate/Certificant Code of Conduct. Infringements of the NBCOT Code of Conduct are investigated to determine appropriate disciplinary action.