Ariz. Admin. Code § R9-16-205 - Initial Application for a Temporary Speech-language Pathologist

A. Except as provided in subsection (B) and before the expiration date of the audiologist's license, a licensed audiologist or audiologist who fits and dispenses hearing aids shall submit to the Department:

1. A renewal application in a format provided by the Department that contains:

a. The applicant's name, home address, telephone number, and e-mail address;

b. If applicable, the applicant's business address and telephone number;

c. If applicable, the name of the applicant's employer, including the employer's business address and telephone number;

d. The applicant's license number and date of expiration;

e. Since the previous license application, whether the applicant has been convicted of a felony or a misdemeanor involving moral turpitude in this or another state;

f. If the applicant was convicted of a felony or a misdemeanor involving moral turpitude:

i. The date of the conviction,

ii. The state or jurisdiction of the conviction,

iii. An explanation of the crime of which the applicant was convicted, and

iv. The disposition of the case;

g. Whether the applicant has had, within two years before the renewal application date, an audiologist license suspended or revoked by any state;

h. An attestation that the information submitted is true and accurate; and

i. The applicant's signature and date of signature;

2. Documentation of the continuing education required in R9-16-208, completed within the two years before the expiration date of the license, including:

a. The name of the individual or organization providing the course;

b. The date and location where the course was provided;

c. The title of each course attended;

d. A description of each course's content;

e. The name of the instructor;

f. The instructor's education, training, and experience background, if applicable; and

g. The number of continuing education hours earned for each course; and

3. A $200 license renewal fee.

B. In addition to the documentation and renewal fee in subsection (A), an applicant who submits a renewal application within 30 calendar days after the license expiration date shall submit a $25 late fee.

C. An applicant who does not submit the documentation and the fee in subsection (A) and, if applicable, (B) within 30 calendar days after the license expiration date shall apply for a new license in R9-16-202 .

D. If an applicant applies for a license according to R9-16-202 more than 30 calendar days but less than one year after the expiration date of the applicant's previous license, the applicant:

1. Is not required to submit ETSNEA documentation, and

2. Shall submit documentation of continuing education according to R9-16-208, completed within the two years before the date of application.

E. The Department shall review the application packet for a renewal license to practice as an audiologist or an audiologist to fit and dispense hearing aids according to R9-16-209 and Table 2.1.

A. In addition to complying with R9-16-202(A), an applicant for initial licensure as a temporary speech-language pathologist shall submit to the Department the following:

1. A transcript or equivalent documentation issued to the applicant by an accredited college or university after the applicant's completion of a master's degree consistent with the standards of this state's universities, as required in A.R.S. § 36-1940.01(A)(2)(a)

2. Completion of a clinical practicum, as required in A.R.S. § 36-1940.01(A)(2)(b).

3. Documentation of the applicant's completion of the ETSNESLP as required in A.R.S. § 36-1940.01(A)(3).

4. Documentation of the applicant's clinical fellowship agreement that includes:

a. The applicant's name, home address, and telephone number;

b. The clinical fellowship supervisor's name, business address, telephone number, and speech-language pathology license number;

c. The name and address where the clinical fellowship will take place;

d. A statement by the clinical fellowship supervisor agreeing to comply with R9-16-209 ; and

e. The signatures of the applicant and the clinical fellowship supervisor.

B. A temporary license issued is effective for 12 months from the date of issuance.

C. A temporary license may be renewed only once.

D. An applicant issued a temporary speech-language pathologist license shall:

1. Practice under the supervision of a licensed speech-language pathologist, and

2. Not practice under the supervision of an individual who has a temporary speech-language pathologist license.

Notes

Ariz. Admin. Code § R9-16-205

Former Section R9-16-205 repealed, new Section R9-16-205 adopted effective January 23, 1978 (Supp. 78-1). Repealed effective March 14, 1994 (Supp. 94-1). Adopted by final rulemaking at 5 A.A.R. 4359, effective October 28, 1999 (Supp. 99-4). Amended by exempt rulemaking at 20 A.A.R. 1998, effective 7/1/2014. Adopted by final expedited rulemaking at 26 A.A.R. 816, effective 4/8/2020.