REGULATIONS
Vol. 35 Iss. 19 - May 13, 2019

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY
Chapter 21
Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Title of Regulation: 18VAC30-21. Regulations Governing Audiology and Speech-Language Pathology.

Contact Information: Elaine J. Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, or email elaine.yeatts@dhp.virginia.gov.

FORMS (18VAC30-21)

Continuing Education Form (rev. 3/2015)

Instructions/Checklist and Application for Audiology or Speech-Language Pathology Licensure in Virginia (rev. 3/2019)

Instructions/Checklist and Application for a Provisional License (rev. 3/2019)

Instructions/Checklist and Application for a School Speech-Language Pathologist without Virginia Board of Education Endorsement (rev. 3/2019)

Instructions/Checklist and Application for a School Speech-Language Pathologist with Virginia Board of Education Endorsement (rev. 3/2019)

Instructions/Checklist and Application for Reinstatement of an Expired Virginia License (rev. 3/2019)

Instructions/Checklist and Application for Reactivation of an Inactive Current License (rev. 3/2019)

Licensure Verification Form (rev. 3/2019)

Employment Verification Form (rev. 3/2019)

Continuing Education Reporting Form (rev. 3/2017)

Continuing Education (CE) Credit Form for Volunteer Practice (rev. 3/2019)

Request for Verification of a Virginia License Form (rev. 3/2019)

Name/Address Change Form (rev. 3/2019)

Sponsor Certification for Volunteer Registration Form (rev. 3/2019)

Application for Registration for Volunteer Practice (rev. 3/2019)

VA.R. Doc. No. R19-5948; Filed April 15, 2019, 4:14 p.m.