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State of Ohio OccupationalTherapy, Physiotherapy, andAthleticTrainersBoard CertificationofEntryLevelEducation Section:Thisportionmustbecompletedbytheapplicant. Pleaseprintortype. Name(First, Middle,
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This form is an annual report that must be submitted.
Any individual or entity who meets the criteria outlined by the governing body.
The form must be completed with accurate and up-to-date information.
The purpose of this form is to provide important information to the governing body for regulatory purposes.
Information such as financial data, operational details, and compliance with regulations must be reported.
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