• Occupational Therapy/COTA Skills Checklist

  • Answer Key:

    1. No Experience

    2. Limited Experience

    3. Experienced

    4. Very Experienced

  • Clinical Settings
    Rows
  • Computerized Charting
    Rows
  • Knowledge of Payment Sources
    Rows
  • Modalities/Skills
    Rows
  • Neurologic
    Rows
  • Orthopedic
    Rows
  • Sports
    Rows
  • Prosthetics/Orthotics
    Rows
  • Pediatrics
    Rows
  • Additional Responsibilities
    Rows
  • Age Specific
    Rows

  • I attest that this checklist represents a true reflection of my experience to the best of my knowledge.  By electronically signing this form I give my permission for it to be shared with facilities as a way to assess my skill level and be considered for employment opportunities.  

  •  -
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: