Occupational therapy services via telehealth for individuals with mental health challenges and chronic conditions do not yet exist in Washington State. The purpose of this capstone is to examine the feasibility of an occupational therapy telehealth business for this population and to create a business proposal to increase the availability of occupational therapy mental health services. This paper examines recent literature, discusses the implications of the business for occupation therapy, and includes a business proposal for a novel telehealth business for occupational therapy services for clients with mental health challenges and chronic conditions. Current research cites an increasing need for mental health services and demonstrates the efficacy of a telehealth business model to address these needs. A business proposal, including an executive summary, market analysis, and financial projections, details the process of starting this novel business. Overall, the evidence and business proposal support the need and efficacy of a telehealth occupational therapy business for people with mental health challenges and chronic conditions.