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Providing Virtual (Remote) Services

Virtual (remote) services refer to using information and communication technologies to provide occupational therapy services when clients and occupational therapists (OTs) are not together in-person.

Virtual services (also known as remote practice, telepractice, online or virtual care) can include phone calls, video conferencing, or other technology-assisted formats.

Occupational therapists providing virtual services are encouraged to review and follow the College's Virtual Services guidance document.


Effective December 1, 2023, occupational therapists registered in Ontario providing virtual services

To clients located in British Columbia: occupational therapists must be registered in British Columbia to provide virtual services.

To clients located in Quebec or Saskatchewan: occupational therapists must contact the regulators in these provinces to obtain special authorization to provide virtual services.

To clients located in all other province and territories: occupational therapists can provide virtual services under their Ontario registration.

To clients outside Canada:  occupational therapists should contact the regulatory authority in that region and determine if registration is required to provide virtual occupational therapy services.

For occupational therapists registered to practice in British Columbia

The occupational therapist must register to practice in Ontario to provide virtual services to clients in Ontario. This is a change effective December 1, 2023.

It is your responsibility to advise any current clients in Ontario about this change. Contact COTO immediately to apply if you wish to continue providing remote services in Ontario.

Apply to register as an occupational therapist in Ontario.

When an occupational therapist does not need to be registered in the secondary jurisdiction

  • The occupational therapist is providing education, in the form of an online workshop/ webinar, etc. to an audience in another province(s). The presenting therapist(s) must introduce themselves as an occupational therapist currently registered/licensed to practice in their own jurisdiction.
  • The client is located in a province other than British Columbia.


The rules for in-person services

The rules for in-person services are unchanged. If you are providing in-person services to a client residing in Ontario, you must obtain temporary or general registration in Ontario.

For more information, see the ACOTRO Position Statement on Remote Practice.

Considerations when providing virtual services to clients in Ontario

It is expected that occupational therapists providing virtual services to clients in Ontario follow the rules of the province where they are regulated.

The occupational therapist must:

  • Disclose the province where they are registered/licensed, to their clients.
  • Notify the client of the location from which they are providing the service.
  • Only practice within the limits of the certification of registration and competencies in the province where they are registered.
  • Follow the regulatory Code of Ethics and applicable professional standards and/or guidelines in the jurisdiction where they are registered/licensed.
  • Document the occupational therapy assessment and/or treatment as per provincial standards and guidelines.
  • Ensure their liability insurance provides coverage for virtual activities.
  • Ensure they have adequate information about resources in the location where the client resides.
  • Have a contingency plan should virtual services be no longer appropriate.
  • Determine if remote practice is the appropriate format for delivering the occupational therapy service.
  • Ensure that the technology at both ends (client’s location and therapist’s location) is in good working order and utilizes safeguards for confidentiality.
  • Carry out informed consent for the use of remote practice, including risks and limitations of remote practice; and the collection, use and disclosure of personal health information.
  • Take necessary measures to maintain the client’s privacy and confidentiality of their personal health information.
  • Develop a process to deal with any adverse or unexpected events during a remote practice session. For example: fall, medical emergency, etc.
  • Establish and maintain professional boundaries during remote practice sessions.
  • Discuss any additional risks and benefits of receiving virtual services.

For more, review the College's guidance on Virtual Services.

What if a client has concerns about the occupational therapy services they received?

Occupational therapists must abide by regulatory Code of Ethics and applicable professional standards and guidance in the province where they are regulated.

If a client has concerns about the services they received, they can file a complaint with any regulatory organization where the occupational therapist is registered.