AZ Board of Occupational Therapy - Extension Request for CEs
If you are unable to complete your continuing education hours in time for your renewal because of COVID-19, the Board may grant you a six-month extension of your license expiration date.
Email address *
Name *
License Number *
By submitting this form, I attest that, because of COVID-19, I am unable to complete the required continuing education in time for my license renewal and require a six-month license extension. Exit from this window if you do not wish to submit the request.
Never submit passwords through Google Forms.
This form was created inside of State of Arizona. Report Abuse