Kentucky Board of Speech-Language Pathology & Audiology

Online Renewal Instructions

Applications & Forms

SLP & AUD - Application Information Sheet

SLPA - Application Information Sheet

SLP & AUD - License Application Form

SLP & AUD - License Application Form [WORD - 176KB] 

SLP & AUD - INTERIM License Application Form

SLP & AUD - INTERIM License Application Form [WORD - 295KB]

SLPA - License Application Form

SLPA - License Application Form [WORD - 312KB]

SLPA - INTERIM License Application Form

SLPA - INTERIM License Application Form [WORD - 277KB]

SLP & AUD - INTERIM Guidelines for PPE

SLPA - INTERIM PPE Report

SLPA - INTERIM Guidelines for PPE

SLPA - INTERIM Post Graduate Evaluation

SLPA - INTERIM Post Graduate Evaluation [WORD - 193KB]

Change in Supervision/PPE Form

Change in Supervision/PPE Form [WORD - 228KB]

SLPA - INTERIM Guidelines for Change in Supervision/PPE Form

SLP & AUD - INTERIM Change in Supervision/PPE Form

SLP & AUD - INTERIM Change in Supervision/PPE Form [WORD - 277KB]

Reinstatement Application

Reinstatement Application [WORD - 277KB]

Continuing Education Approval Form

Continuing Education Approval Form [WORD - 211KB]

Application for Extension of INTERIM License

Name/Address Change Form

Name/Address Change Form [WORD - 203KB]

Complaint Form

Complaint Form [WORD - 99KB]

Speech-Language Pathology & Audiology Renewal Form

Speech-Language Pathology & Audiology Assistant Renewal Form