Applications and forms
APPLY ONLINE for the following license types:
Application for Provisional Licensure as an Audiologist
Application for Provisional Licensure as a Speech-Language Pathologist
Current ASHA Certification
Speech-Language Pathology by Education, Experience (CFY) and Examination (Praxis)
Audiology by Education and Examination
Reciprocity
Current Practitioner
reactivation
Additional Applications
Speech-Language Pathology and Audiology Assistant (PDF)
Approval of Continuing Education (PDF)
forms
Current Pennsylvania Employer Form (PDF)
Name and/or Address Change
NOTE: As a result of document fraud and in an effort to protect its licensees, the Board will only provide direct source verification of your license to another state licensing agency.
<< Previous
