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Name Changes

All licensees that have undergone a legal name change via marriage, divorce or otherwise, please be advised that in order for the Board to change the name in which your OT or OTA license is issued, you are REQUIRED to submit the following: 

  1. Complete the Name Change Request form
  2. A certified marriage certificate specifying the name change following marriage; or
  3. A certified divorce or dissolution of marriage decree specifying the name change (send only the first page, the page indicating the name change, and the signature pages); or
  4. Other certified court order specifying the name change
  5. Do not submit foreign marriage certificates that do not reflect your name change following marriage, as the Board is unable to accept them for purposes of changing your name on your license
    • If requesting new license card and/or a new wall certificate, mail completed name change form, supporting documents and fee check to the Board address. Fees are listed on the name change request form
    • If a name change only (no duplicate documents) you may email the information to the Board 

Minnesota statute §148.6428, requires all licensees to maintain current name, address, and primary employment information with the Board. These changes must be submitted to the Board within thirty (30) days of the change.

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