Online Services | Commonwealth Sites | Help | Governor

Board of Audiology and Speech Pathology
Applications & Forms

The below documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer 97/2000 to view and print DHP's documents.

Audiology Applicants Only

ASHA (American Speech-Language-Hearing Association) or ABA (American Board of Audiology)

Checklist for Audiology Applicants by ASHAor ABA

Application for a License to Practice Audiology


Audiology Provisional License

Checklist for Applicants Requesting Provisional License to Practice Audiology

Application for a Provisional License to Practice Audiology

 

Speech-Language Pathology Applicants Only

Education

Checklist for Applicants by Education

Application for a License to Practice Speech-Language Pathology by Education


ASHA (American Speech-Language-Hearing Association)

Checklist for Applicants by ASHA Certification

Application for a License to Practice Speech-Language Pathology by ASHA Certification


School Speech-Language Pathology

Checklist for School Speech-Language Pathologist Application

Application for Licensure as a School Speech-Language Pathologist

 

Reinstatement Forms

Checklist for Reinstatement of License to Practice as an Audiologist or Speech-Language Pathologist

Reinstatement Application for License to Practice as an Audiologist or Speech-Language Pathologist

Checklist for Reinstatement of License to Practice as a School Speech-Language Pathologist

Reinstatement Application for License to Practice as a School Speech-Language Pathologist

Reinstatement Application for Inactive to Active License

 

Continuing Competency Forms

Continuing Competency Activity and Assessment Form - includes instructions

Application for approval as a Continuing Competency Sponsor