| Form |
Format |
Description |
Last Updated |
| Licensing |
| Application for Licensure |
PDF
|
Licensure application for Speech-Language Pathologists and Audiologists. |
7/1/09 |
| Application for Conditional Licensure |
PDF |
Licensure application for SLPs and Audiologists in their CFY. |
7/1/09 |
| Conditional License Renewal / Upgrade to Regular Licensure |
PDF |
Form to renew conditional licensure after initial year or to upgrade to a regular license |
7/6/07 |
| Application for Speech-Language Pathology Assistant Certificate |
PDF |
Certification application for Speech-Language Pathology Assistants. |
7/1/09 |
| SLPA Competency Checklist |
PDF |
Competency Checklist for 100 hours of required clinical interaction |
4/22/08 |
Application for Permit
to Supervise SLPAs |
PDF |
For TSPC-Licensed Speech-Language Pathologists working in public schools |
7/1/09 |
Supervision |
Petition for Special Approval for Supervision
of Speech-Language Pathology Assistants
|
PDF |
Education Service Districts and School Districts must use this form to apply for approval for an exception to the usual requirements for Direct Supervision of SLPAs by licensed SLPs. |
8.18.08 |
| Report of Supervisor for SLPA supervision |
PDF |
For SLPAs who were unable to report supervision information when they applied. |
9/21/09 |
| Notification of change in SLPA supervision. |
PDF |
Form to notify the Board of a change in supervisors for a speech-language pathology assistant. |
9/21/09 |
| Smart Form for Supervision of SLPAs in Clinical Interaction |
|
Questions and Answers (PDF)
Sample Smart Form (XLS)
Blank Smart Form (XLS) |
10/19/09 |
Professional Development |
| Professional Development Group Activity Special Approval |
PDF |
Application for special approval of a group of activities. |
7/15/08 |
| Professional Development Activity Special Approval |
PDF |
Application for special approval of a professional development activity. |
7/15/08 |
| Professional Development Report Form |
PDF |
Form for reporting completed professional development to the board. |
8/5/08 |
Miscellaneous |
| Verification of License request to submit to other Jurisdiction |
PDF |
This is to request verification of your license from OTHER JURISDICTIONS (not OR) to be sent to Oregon. |
4/1/09 |
