ADHS will be performing maintenance on the Medical Marijuana systems starting on Saturday, January 24, 2015 at 10 PM expected to be completed by Sunday, January 25, 2015 at 4 AM. During this time, Medical Marijuana Online Registry Applications will be unavailable. We apologize for the inconvenience this maintenance downtime may cause. If the process is completed earlier, the systems will be made available at an earlier time.
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||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
- Renewal Application for all Speech and Hearing Provider Disciplines (except BHAD)
- Renewal Business Organization Hearing Aid Dispenser License 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.