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Forms
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Article Content | Online Forms |
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License Inquiry (public licensee database)
Please scroll down to find links to profession-specific forms. |
| Consumer Forms |
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Consumer Complaint Form
Public Records Request Form |
| For Licensees and Applicants |
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Customer Information Update Form - Word PDF
Renewal, Late Fee, Address or Employment Change, Replacement License
Affidavit of Licensure - Word PDF
Accommodation Request - Word PDF
(Americans with Disabilities Act)
Fingerprint Processing Instructions
NAME CHANGES Information / Requirements
NAME CHANGE Form - Word PDF
Written and Practical Examination Application - Word PDF |
| Submit Form(s) to OHLA |
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 You may print and return completed forms to:
Oregon Health Licensing Agency
700 Summer Street NE, Suite 320
Salem, OR 97301-1287 |
| Profession-Specific Forms |
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Body Art Practitioners (body piercing, electrology, tattooing)
Cosmetology (barbers, estheticians, hair designers/stylists, nail technicians)
Denturists
Dietitians
Environmental Health Specialists
Hearing Aids Specialists
Midwives, Direct Entry
Nursing Home Administrators
Respiratory Therapists / Polysomnographic Technologists
Sex Offender Therapists
Waste Water Specialists |
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