ADHS Division of Licensing Services
Special License Application Forms
Attention Temporary SLP and SLPA Applicants
Do not submit incomplete applications in an attempt to 'get the process started' for a license. This means that if the license you are applying for has education completion requirements, your official transcripts must reflect that the required coursework or degree has been completed or conferred. All required documentation are to be included with the application, not sent separately.
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 Application for all Speech and Hearing Provider Disciplines (except BHAD)
- Renewal Application for all Speech and Hearing Provider Disciplines (except BHAD)
- Online License Renewal Application (ONLY for Regular AUD, DA, HAD, SLP, and SLP-L licenses. TEMP, ASST, and ORG licensees CANNOT renew using the online portal.)
- Application for Business Organization Hearing Aid Dispenser (both Initial and Renewal)
Licensee Information Update Forms
- Temporary Speech-Language Pathologist Clinical Fellowship Update
- Temporary Hearing Aid Dispenser Sponsorship Update
- Temporary Hearing Aid Dispenser Sponsorship Termination Notice
- SLPA Supervisor Update
- SPHR Licensee Change of Address Notification
Chapter 20 Program Approval Forms
- DUI Approval Application Form
- DUI Renewal Application Form
- Domestic Violence Offender Approval Application Form
- Domestic Violence Offender Approval Renewal Application Form
Information provided in PDF files, unless otherwise indicated.