Forms

An individual whose license has been expired for less than five years may apply for reinstatement of their license. These individual must call the Board and request a reinstatement for and inquire about the current fees for reinstatement of an expired license. Contact the Board at 410-764-4725 to request a reinstatment form.

An individual whose license has been expired for more than five years must reapply for licensure and meet/exceed all current requirements for licensure. Use the appropriate form in the "Licensure Forms" section and submit all required materials and fees to the Board.

Criminal History Records Check Instructions

In State Instructions

Out-of-State Instructions

LiveScan Pre-Registration Application

Licensure Forms

Important Notice to Recent Graduates

Recent graduates with a Master's in speech-language pathology or a Doctorate in audiology are advised that national examination score reporting by ETS is now completely electronic. Recent graduates that did not indicate the Stateof Maryland as a licensure body to receive electronic score reporting are advised to contact ETS immediately to take the necessary action required by ETS so that the Board can view an applicant's score reports. Failure to address this may result in a delay in the issuance of a license to an applicant.

Audiology: Application for Full Licensure
Audiology: Application for Limited Licensure
Speech-Language Pathologists Full Licensure
Speech-Language Pathologists Limited Licensure
Speech-Language Pathologists Assistant Limited Licensure
Speech-Language Pathologists Assistant Full Licensure
Speech-Language Pathologists Limited License Renewal
Speech-Language Pathologists Assistant Limited License Renewal
Hearing Aid Dispenser Application for HAD Examination or HAD Limited License Examination
Application For Waiver of Hearing Aid Dispenser Examination
Hearing Aid Dispenser Limited License Renewal
Replacement License Request
Walk-In Administrative Procedure

Important Notice for Active Duty Military and Recently Discharged Military Veterans & Spouses

Pursuant to the Veterans Full Employment Act of 2013, military veterans discharged within one (1) year of application for licensing or registration qualify for expedited processing of applications and review of equivalency requests for military training. The Board will expedite review and processing of applications of any military schools or courses submitted as qualifying equivalents for required educational licensing/registration educational standards. The Board extends these privileges to active duty military, including reservists called to active duty for training or deployment. These provisions also fully apply to spouses of active duty and qualifying veterans.

To further comply with the letter and spirit of the Act, counseling assistance is available to qualifying veterans, active duty personnel, and spouses on application, licensing and credentialing issues. The Acting Executive Director, Zoann Mouzone, serves as the Board liaison and counselor to any qualifying veteran, active duty service member, or dependant spouse who requires information, guidance or assistance on issues relating to licensing. He may be reached via email at Zoann.Mouzone@maryland.gov or by phone at 410-764-4723.

This Board is prepared to assist all qualified military veterans in any way possible to meet the Act’s provisions. Should any Act provisions be further amended (or as further information becomes available) information will be posted on this website.



Law Exams

Note to Applicants: Please use the statute and regulations under the Regulations tab to complete the Law Exam. A completed Law Exam must be on file for an application to be considered complete.

Audiologists
Hearing Aid Dispensers
Speech-Language Pathologists
Speech-Language Pathologists Assistants

Continuing Education Forms

Individuals or organizations submitting requests for approval of Continuing Education programs or activities must submit an application (select below). Requestors should retain a copy of their application for their records. The Board will return the application noting approval or denial. Requestors should contact the Board if they have not received a response within three (3) weeks of submission. Applications may not be submitted via fax.

Application for Prior Approval of a Continuing Education Program/Activity
Application for Approval of a Continuing Education Program for Individual Participation

Miscellaneous Forms

All licensees must submit a change of mailing address form to the Board within 30 days of the change. This includes changes to e-mail addresses.

Name change forms must be submitted within 30 days of the change. If a revised license is requested a $5.00 duplicate license fee must be submitted with the name change forms.

The inactive status form may be used only during the renewal process (i.e., within 60 days prior to the expiration date of the license).

Change of Address Form
HAD Practical Exam Schedule
Hearing Aid Dispenser - Place of Business
Inactive Status Form
Name Change Form

Consumers

Complaint Form