Forms / Applications

 APPLICATIONS

  F1-ARA APPRENTICE REGISTRATION APPLICATION

   see F1 PLAN OF SUPERVISION (now part of F1 application)

   F3-RAE REPORT OF APPRENTICESHIP EXPERIENCE

   F4-ALER APPLICATON FOR LICENSE / EXAM REGISTRATION

   F8-RSA  REGISTERED SPONSOR APPLICATION

  use F1  RENEW or REPLACE APPRENTICE CERTIFICATE APPLICATION

   F22-ALR   2022 ANNUAL LICENSE RENEWAL APPLICATION
(**2022 renewal form not available until Feb 1, 2022**)

   F10  APPLICATION FOR LICENSE / EXAM REGISTRATION
(for military applicants only)

   LME   HEARING AID SPECIALIST LICENSURE BY MILITARY ENDORSEMENT

  AFFIDAVITS

  F1-ARA  APPRENTICE REGISTRATION AFFIDAVIT

  F3-RAE REPORT OF APPRENTICESHIP EXPERIENCE AFFIDAVIT

  F4-ALER  APPLICATON FOR LICENSE / EXAM REGISTRATION AFFIDAVIT

  F5-OWAR OTOLARYNGOLOGIST AFFIDAVIT (Waiver of Apprenticeship)

  F6-LWAR LICENSED OUT OF STATE AFFIDAVIT (Waiver of Apprenticeship)

  F7-VOL VERIFICATION OF LICENSE form

  F8-RSA   REGISTERED SPONSOR AFFIDAVIT

  use F1   RENEW or REPLACE APPRENTICE CERTIFICATE AFFIDAVIT

  FORMS

BGC BACKGROUND CHECK (USE PACKAGE CODE "NC16")

CAP COMPLAINT AGAINST PROVIDER (to Committee on Investigations)

CE CONTINUING EDUCATION (forms, reports, applications)

LOG LOG OF SUPERVISION

RAC REGISTER as AUTHORIZED CALIBRATER

RER REQUEST EXAM REVIEW (submit within 20 days of Notice of Results)

RLQ RELINQUISH LICENSE (Au.D. exempt from licensure)

  F11 ADDRESS CHANGE

  F7-VOL VERIFICATION OF LICENSE form