Application and Instructions for a Temporary License: New Graduate
Instructions:
Click here to print this page as a checklist. (PDF:22.24k: 3 pages)
- Print these instructions and use them as a check list.
Complete these steps to apply for Temporary License: New Graduate
- Print the application form using this link:
Application for Temporary License: New Graduate
(Waiver and Release form included) (PDF:22.24k: 3 pages)
- Complete, sign and date Part I of the application.
- Complete, sign and date Waiver Authorization & Release form.
- The occupational therapist that will be your supervisor must complete and sign Part II of the application form. If you have additional supervisors, each supervisor must complete page 2 of the temporary application.
- Make out a check or money order for $50.00 payable to: Treasurer, State of Minnesota.
All fees are non-refundable
- Request an official transcript be sent directly to MDH from the educational institution where you completed your occupational therapy education. We will not accept a transcript from you unless it is in an unopened, sealed envelope. Our address is:
Minnesota Department of Health
Health Occupations Program
PO Box 64882
St. Paul, MN 55164-0882 - Make a copy of the completed application for your records.
- Mail the completed, original temporary application and fees to the address above.
Note: Once MDH has received your completed application, fee and transcripts, your check or money order is deposited and the application is reviewed and processed. Issuance of your temporary license may take 3-7 business days after all documents are received. If you provide an employer fax number on your application, your approval will be faxed to your work place on the day of issuance. A copy of the approval will also be mailed to you and your supervisor.
- After you have mailed in your application, if you need to add additional work locations
to your temporary application, you will need to complete a new temporary application. If you are just adding an additional supervisor to a current work location, you and the new supervisor need to complete page 2.
- To check if your credential has been issued you can go to our Website at:
http://pqc.health.state.mn.us/hopVerify/loginAction.do
Your name will appear on the website the day after your credential has been issued.
Questions: Please call Kim Ruberg at 651-201-3725 or email me at kimberly.ruberg@state.mn.us