20 CSR 2150-4.055 - Applicants for Provisional Licensure
(1)
Applicants for provisional licensure are required to make application on forms
prepared by the board.
(2) No
application will be considered unless fully and completely made out on the
specified form and properly attested.
(3) Applications shall be sent to the State
Board of Registration for the Healing Arts, PO Box 4, Jefferson City, MO
65102.
(4) The fee for provisional
licensure shall be an appropriate fee, to be established by the board. The fee
shall be sent in the form of a bank draft, post office money order or express
money order payable on a United States Bank made payable to the State Board of
Registration for the Healing Arts. Personal and/or corporate checks will not be
accepted. No application will be processed until the licensure fee is
received.
(5) The applicant shall
attach to the application a recent photograph not larger than three and
one-half inches by five inches (3 1/2" × 5").
(6) Applicants for provisional licensure must
submit the following documentation:
(A) Proof
of receipt of a master's or doctoral degree from an institution accredited by
the American Speech-Language-Hearing Association accrediting body, in the area
for which licensure is sought. Documentation shall be provided on the
board-prescribed form and submitted directly to the board from the program
director of the accredited institution;
(B) Applicants shall provide, on forms
prescribed by the board, a plan for completion of the supervised postgraduate
professional experience. This form must be signed by a supervisor holding
current permanent Missouri licensure, in the area in which the applicant seeks
licensure. The plan shall consist of at least thirty-six (36) weeks of fulltime
professional experience. A minimum of thirty-five (35) hours of work per week
constitutes full-time employment. If the applicant works twenty-nine to
thirty-four (29-34) hours per week, the length of the experience must be at
least forty-eight (48) weeks. If the applicant works twenty-two to twenty-eight
(22-28) hours per week, the length of the experience must be at least sixty
(60) weeks. If the applicant works fifteen to twenty-one (15-21) hours per
week, the length of the experience must be at least seventy-two (72)
weeks;
(C) At the conclusion of the
supervised postgraduate experience period, the supervisor and the provisional
licensee shall sign and submit a board prescribed report which documents
completion of the experience; and
(D) Verification of licensure or registration
to practice in another state or territory shall be submitted to the board
directly from the licensing/registration agency.
(7) Provisional licensees who change their
clinical fellowship site, clinical fellowship supervisor, or the number of
hours worked per week, must submit, on forms prescribed by the board, the
revised plan for completion of the supervised postgraduate professional
experience, no later than four (4) weeks after initiating the change. The
change must be approved by the board in order to receive credit.
(8) Applicants seeking provisional licensure
in both speech-language pathology and audiology shall meet the qualifications
and submit the required documentation as stated above for both
professions.
(9) The provisional
license is valid for one (1) year. The license may be renewed one (1) time with
board approval. Applicants may apply for provisional licensure renewal pursuant
to 20 CSR
2150-4.056.
(10) When an applicant has filed his/her
application and the appropriate fee for provisional licensure, and the
application is denied by the board or subsequently withdrawn by the applicant,
the fee will be retained by the board as a service charge.
(11) An applicant may withdraw his/her
application for provisional licensure anytime prior to the board's vote on
his/her candidacy for licensure.
Notes
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