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|
|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 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
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
Information provided in PDF files, unless otherwise indicated.