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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 jurisdiction, either mail/fax the jurisdictions verification request form to our office, or email our office with the name and address of the jurisdiction you would like verification to be sent to. 
- 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
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Conditional Speech-Language Pathologist - Site or Supervision Change Form

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