Forms

Licensure Forms

*Please expect an additional 2-3 weeks processing time for all applications that are mailed in.

Application For Speech-Language Pathologist or Provisional Speech-Language

Application For Speech-Language Pathology Assistants or Provisional Speech-Language Pathology Assistants

Application For Audiologist

Supervision Agreement Form

Supervision Form 100

Supervision Form 200

RENEWAL FORM for All Licensees - 2017

Other Forms

CE Pre-Approval Request

Fact Sheet on Certification vs. Licensure

Mailing List