Verification Request

To request verification of your WV license, please print and complete the form below and include $30 fee.

 

Verification Request form

 

To pay with credit card, click here.  Scan and email form and payment receipt to vmalnikoff@wvbot.org.

 

To pay with check, mail completed form with check for $30 to the address shown on the form.

(Make check payable to the WV Board of Occupational Therapy)