Forms and Resources


Licensure Forms


Application For Practice via Telehealth

Supervision Agreement Form

Supervision Form 100

Supervision Form 200 - weekends shaded 2020-2021

Supervision Form 200 - weekends shaded 2021-2022

Notarized Statement for Renewal 2021

Other Forms

CE Flyer

CE Pre-Approval Request

Code of Ethics (Modified Format for Training Purposes)

Criminal Background Check Authorization Form

Criminal Background Check Instruction Sheet

Criminal Background Check RAP Disclosure Form

Fact Sheet on Certification vs. Licensure

Mailing List Request

Provisional License Process Infographic

 *Verification of Licensure request forms can be found by logging into your licensee dashboard and clicking on Forms.



American Academy of Audiology (AAA)

American Speech-Language-Hearing-Association (ASHA)

Centers for Medicare & Medicaid Services

Identify the Signs of Communication Disorders

Louisiana Academy of Audiology (LAA)

Louisiana Department of Education: The Career Development Network for Louisiana Educators

Louisiana Speech-Language-Hearing Association (LSHA)

Louisiana State Department of Education

National Council of State Boards of Examiners for Speech-Language Pathology and Audiology (NCSB)

Speech Pathologists and Audiologists in LA Schools (SPALS)

Medicare and Medicare related information