Regulation of Occupational Therapy Practice

The profession of occupational therapy is regulated in the province under the Regulated Health Professions Act, 1991 and the Occupational Therapy Act, 1991

Individuals who practice in Ontario as an occupational therapist must be registered with the regulatory body, the College of Occupational Therapists of Ontario (COTO). Unless registered, the title of occupational therapist cannot be used. The scope of occupational therapy practice is defined in the Occupational Therapy Act but is not protected and remains in the public domain as are the scopes of practice of other regulated health professions in the province.

Ontario's health professions regulation focuses on the regulation of key activities deemed potentially harmful to the public. These activities, identified as "controlled acts", are restricted to delegated professions. The profession of occupational therapy is not delegated to perform any of the 13 designated controlled acts, however when the controlled act of psychotherapy is proclaimed, the profession will be authorized to perform this controlled act.

The practice of occupational therapy includes direct service, education, consultation, research, administration and/or sales. Registration with the College qualifies occupational therapists to use the title "Occupational Therapist" or "O.T.", and the designation "OT Reg. (Ont.)". 

College of Occupational Therapists of Ontario - The College of Occupational Therapists of Ontario (COTO) has a mandate to protect the public interest by regulating practice. Registration assures the public that the occupational therapist has met entry-to-practice requirements, and meets the College's standards of practice and quality assurance requirements. A complaints and discipline process provides the public with a channel through which they may address concerns they may have about occupational therapy services they have received.  Occupational Therapists seeking to work in Ontario are encouraged to engage the COTO registration process early as the paper work can be time consuming. The College may be contacted at 1-800-890-6570 or 416-214-1177. Visit the COTO website or contact them via email at

The College establishes eligibility criteria for registration and the practice of occupational therapy in the province.  View the 
COTO registration requirements and processes

Consider the following requirements of registration:

Academic Preparation
Applicants for registration must have a Bachelor of Science degree or Master of Science in Occupational Therapy obtained in Ontario or an academic qualification considered equivalent by the College's Registration Committee, and have successfully completed 1000 hours of fieldwork or clinical practicum as part of the education program.
Practice Currency
Applicants must have 600 hours of occupational therapy practice within the last 3 years; or have successfully completed a College approved Refresher Program within the last 18 months; or have graduation from an occupational therapy program within the last 18 months. 

National Certification Exam
One component of the COTO registration requirements is the successful completion of a certification exam. This exam is currently administered by the Canadian Association of Occupational Therapists (CAOT) and is administered twice annually in July and November. Contact the CAOT for information regarding the examination registration process and upcoming dates. In the event that it is not possible to write or successfully complete the exam in advance of seeking employment in Ontario, COTO does make provision for a Provisional Practising Certificate which enables individuals to seek employment but restricts practice to employment situations that can provide for supervision from a registered occupational  therapist. Provisional registrants are required to write the next available exam following their registration.

Professional Liability Insurance
A further requirement of College registration is that applicants carry a professional liability insurance policy that meets College requirements and includes a Sexual Abuse and Counselling Fund Endorsement. The Ontario Society of Occupational Therapists provides a comprehensive professional liability insurance program which exceeds coverage requirements of the College. This policy includes insurance that protects you in the event of a legal suit, a complaint or any regulatory proceeding which relates to your occupational therapy practice. Occupational therapists living outside of Ontario may join OSOT as Associate Members and have full access to member benefits such as the professional liability insurance program so that they may access the necessary insurance to meet college requirements.