A. An applicant that is a business
organization shall submit to the Department:
1. An application for an initial
hearing aid dispenser license in a format provided by the Department that
contains:
a.
The name of the business
organization;
b.
The business organization's Arizona business name,
address, and telephone number;
c.
The name, address, telephone number, and e-mail
address of the individual authorized by the business organization to be the
designated agent;
d.
The name, business telephone number, and Arizona
hearing aid dispenser license number of each hearing aid dispenser employed by
the business organization in Arizona;
e.
Whether the business organization or a hearing aid
dispenser working for the business organization has had a hearing aid dispenser
license suspended or revoked by any state within two years before the
application date;
f.
Whether the business organization or a hearing aid
dispenser working for the business organization currently is not eligible for
licensing in any state due to a suspension or revocation;
g.
An attestation that information required as part of
the application has been submitted and is true and accurate;
and
h. The signature and date of
signature from the designated agent;
2.
A nonrefundable $100 application fee;
and
3.
A $200 license fee.
B.
The Department shall review an application for an
initial hearing aid dispenser license to a business organization according to
R9-16-316 and Table 3.1.
C.
If the Department does not issue an initial hearing
aid dispenser license to a business organization, the Department shall return
the license fee in subsection (A)(3) to the applicant.
D.
A business organization licensed according to this
Section shall comply with A.R.S. § 36-1910 .
E.
An initial license issued to a business organization
according to this Section is valid for two years from the date of
issue.
A. A licensee, except
for a temporary hearing aid dispenser, shall submit a renewal application in a
Department-provided format that contains:
1.
For an individual licensed as a hearing aid dispenser:
a. The licensee's name, home address,
telephone number, and e-mail address;
b. The licensee's current employment, if
applicable, including:
i. The employer's
name,
ii. The licensee's
position,
iii. Dates of
employment,
iv. The address of the
employer,
v. The supervisor's
name,
vi. The supervisor's email
address, and
vii. The supervisor's
telephone number;
c. The
licensee's license number and expiration date;
d. Since the hearing aid dispenser's previous
license application, whether the licensee has been convicted of a felony or a
misdemeanor in this or another state or jurisdiction;
e. If the licensee was convicted of a felony
or misdemeanor:
i. The date of the
conviction,
ii. The state or
jurisdiction of the conviction,
iii. An explanation of the crime of which the
licensee was convicted, and
iv. The
disposition of the case;
f. Whether the licensee has had a license
revoked or suspended by any state within the previous two years;
g. Whether the licensee is currently
ineligible for licensure in any state because of a prior license revocation or
suspension;
h. Whether the licensee
agrees to allow the Department to submit supplemental requests for information
under
R9-16-314 ;
i. An attestation that the licensee completed
continuing education required under A.R.S. §
36-1904 and that documentation of
completion is available upon request;
j. An attestation that the information
required as part of the application has been submitted and is true and
accurate; and
k. The licensee's
signature and date of signature;
2. Whether the licensee has, within the two
years before the date of the application, had:
a. A license issued under this Article
suspended or revoked; or
b. A
professional license or certificate revoked by another state or jurisdiction;
and
3. A license renewal
fee specified in
R9-16-316 ; or
4. For a business organization licensed as a
hearing aid dispenser:
a. The information in
subsection
R9-16-307(A)(1),
and
b. A license renewal fee
specified in
R9-16-316.
B. A licensee, except for a temporary hearing
aid dispenser, who renews a license within 30 calendar days after the
expiration date of the license, shall submit to the Department:
1. The information and renewal fee required
in subsection (A), and
C. A renewal license issued to a licensee,
except for temporary hearing aid dispenser, is valid for two years after the
expiration date of the previous license issued by the Department.
D. If a licensee does not comply with
subsections (A) or (B), the license is nonrenewable and:
1. The hearing aid dispenser may apply for a
new license according to subsection (E), or
2. The business organization may apply for a
new license according to
R9-16-307.
E. A licensee whose license is nonrenewable,
according to subsection (D)(1), and is within one year after the expiration
date of the hearing aid dispenser's license, the licensee shall submit:
2. An attestation of continuing
education, according to
R9-16-309, completed with
twenty-four months before the date of the date of application; and
3. A nonrefundable application fee and a
license fee specified in
R9-16-316.
F. If allowed in
R9-16-303, a temporary hearing aid
dispenser shall submit at least 30 calendar days before the expiration date on
the license, a renewal application to the Department in a Department-provided
format that contains:
2. The applicant's sponsor's:
a. Name,
b. Business address,
c. Business telephone number, and
d. Arizona hearing aid dispenser license
number;
3. A statement
signed by the sponsor that the sponsor is a licensed hearing aid dispenser who
agrees to train, supervise, and be responsible for the applicant's hearing aid
dispenser practice according to A.R.S. §
36-1905; and
4. A license renewal fee specified in
R9-16-316.
G. A renewal license issued to a licensee
according to subsection (F) is valid for one year after the expiration date of
the previous license issued by the Department.
H. The Department shall review a renewal
application according to
R9-16-314 and Table 3.1.
