APPLICATIONS
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Submission Portal NEW SUBMISSION PLATFORM CERTEMY - LOG IN INFORMATION
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F1-Inital APPRENTICE
REGISTRATION APPLICATION (Initial Application)
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F1-Change APPRENTICE
REGISTRATION APPLICATION (Change of Sponsor)
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F1-Change/Renew APPRENTICE
REGISTRATION APPLICATION (Renewal/Change of Sponsor)
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F3-RAE REPORT
OF APPRENTICESHIP EXPERIENCE
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F4-ALER APPLICATON
FOR LICENSE / EXAM REGISTRATION
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F8-RSA REGISTERED
SPONSOR APPLICATION
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F24-ALR 2024
ANNUAL LICENSE RENEWAL APPLICATION(**2024 renewal form available Feb 1, 2024**)
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F10 APPLICATION
FOR LICENSE / EXAM REGISTRATION (for military applicants only)
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LME HEARING AID SPECIALIST LICENSURE BY MILITARY ENDORSEMENT
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AFFIDAVITS
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F1-ARA APPRENTICE
REGISTRATION AFFIDAVIT
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F3-RAE REPORT
OF APPRENTICESHIP EXPERIENCE AFFIDAVIT
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F4-ALER APPLICATON
FOR LICENSE / EXAM REGISTRATION AFFIDAVIT
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F5-OWAR OTOLARYNGOLOGIST
AFFIDAVIT (Waiver of Apprenticeship)
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F6-LWAR LICENSED
OUT OF STATE AFFIDAVIT (Waiver of Apprenticeship)
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F7-VOL VERIFICATION
OF LICENSE form
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F8-RSA REGISTERED
SPONSOR AFFIDAVIT
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use F1 RENEW
or REPLACE APPRENTICE CERTIFICATE AFFIDAVIT
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FORMS
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BGC BACKGROUND CHECK (USE PACKAGE CODE "NC16")
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CAP COMPLAINT AGAINST PROVIDER (to Committee on Investigations)
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CE CONTINUING
EDUCATION (forms, reports, applications)
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RAC REGISTER
as AUTHORIZED CALIBRATER
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RER REQUEST
EXAM REVIEW (submit within 20 days of Notice of Results)
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RLQ RELINQUISH
LICENSE (Au.D. exempt from licensure)
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F11 ADDRESS
CHANGE
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F7-VOL VERIFICATION
OF LICENSE form
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