ADHS Division of Licensing Services

Special License Application Forms

ALL APPLICANTS: PLEASE compile and submit ALL required documents and information WITH your application. Anything sent separately or missing from your application will delay its completeness. Have original transcripts mailed to you so you can ensure inclusion WITH your application. Original transcripts MUST indicate conferral or completion of the required degrees or coursework.

Notice Regarding Application Fees: A.R.S. § 36-405(C)(1) requires the Department to collect nonrefundable application fees from all health care institutions under its jurisdiction. The amount of the non-refundable application fee is specified in the application. The Department will consider any application received without the application fee to be incomplete.

Initial License Renewal License

The applications in this column are for originating a license; re-applying for an Arizona license that is *non-renewable; or re-applying for an Arizona license that is expired for more than one year.

The applications in this column are for renewing an Arizona license that is currently active or is expired for no more than 30 calendar days.

Audiology or Dispensing Audiology
Audiologist or Dispensing Audiologist Audiologist or Dispensing Audiologist
Hearing Aid Dispensing

Approval to Take Hearing Aid Dispenser Examination (EXAM ONLY)

Temporary Hearing Aid Dispenser Temporary Hearing Aid Dispenser
Hearing Aid Dispenser By Examination Hearing Aid Dispenser
Hearing Aid Dispenser By Reciprocity
Business Organization Hearing Aid Dispenser Business Organization Hearing Aid Dispenser
Speech-Language Pathology
Speech-Language Pathologist Speech-Language Pathologist
Speech-Language Pathologist - Limited Speech-Language Pathologist - Limited
Speech-Language Pathologist AFTER TSLP ONLY  
Temporary Speech-Language Pathologist Temporary Speech-Language Pathologist
Speech-Language Pathologist Assistant Speech-Language Pathologist Assistant
*A non-renewable license is one that is expired for more than 30 days but less than one year. Re-applying for a license during this period requires you submit the Additional Documents Required For A Non-Renewable License form along with the appropriate Initial Application above.

*ONLINE License Renewal Application
(Only Regular AUD, DA, HAD, SLP, and SLP-L licenses can be renewed using the online portal. Temporary, Assistant, and Business Dispenser licenses CANNOT renew using the online portal at this time.)

Licensee Information Update Forms

Information provided in PDF files, unless otherwise indicated.