NOTARIZED APPLICATION: The first six pages of the application must be mailed to the Board’s office at the address listed above, along with the required fee. All questions must be answered. Any question answered “yes” requires further documentation to be submitted. Attach copies of official court documents and an explanation if you have had any criminal convictions or charges, or sanctions by another state licensing board. Approval of registration is at the Board’s discretion.
EDUCATIONAL REQUIREMENTS: The applicant must submit a copy of the college transcript, or certification in health care from a technical school approved by the Board, or certification of completion of an Audiology Assistant Program approved by the Board.
JOB DESCRIPTION: A job description listing the specific duties and activities to be
performed by t he Audiology Assistant.
SUPERVISOR’S DUTIES: The supervisor must:
*Submit a description of a minimum of 40 hours of proposed instruction in specific
duties and activities the assistant will perform.
*Once the application is approved, submit within 30 days of completion the verification statement (Form D) that training was satisfactorily completed.
*Retain documentation of the indirect or direct supervisory activities for two years.