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Concern/Complaint Form

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Licensee Mail List Request Form

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Address Change Form, Name Change Form, Verification of Oregon License

- You can change your address here and it will be electronically submitted. Changes in contact information must be submitted within 30 days of the change.
- You may submit this form by mail, fax, or email attachment. Attach relevant legal document showing the change.
Request to Verify your Oregon SLP/AUD/SLPA License
- To have verification of your Oregon license sent to another state, either mail or fax the other state’s verification request form to our office (971-673-0226), or just email our office (speechaud.board@state.or.us) with the name and address where you need the verification to be sent. We will send a verification letter directly from the Oregon Board to the other state.
We don’t require our licensees to fill out a Board form for this purpose, nor do we charge any fee.  This service is covered through your licensing fee.
- To request to have verification of a license issued by another state agency (Licensing Agency, Educational Agency, or TSPC) sent to the Oregon Board of Examiners.
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Speech-Language Pathology Assistant Supervision Forms

Supervision Change Notices must be submitted within 30 days of the change to avoid a late fee
SLPA Supervision Log "Smart Form"
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Conditional Speech-Language Pathologist - Site or Supervision Change Form

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