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Oklahoma Board of Examiners for Speech-Language Pathology & Audiology
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Home / LICENSE INFORMATION / Forms

 

SPEECH-LANGUAGE PATHOLOGY          ASSISTANT LICENSE

Forms:

Checklist

Speech Assistant Application

Clinical Academic Requirement Form 

Letters of Agreement

First 90 day Supervision Log

SLPA weekly Supervision Log

 

SPEECH-LANGUAGE PATHOLOGY LICENSE

Forms:  

Checklist 

Licensure Application 

 

 

CLINICAL FELLOW LICENSE 

Forms:

Checklist 

CF Application

Letters of Agreement

CF Plan

 

 

 

 

AUDIOLOGY LICENSE 

Forms:

Checklist 

Licensure Application

           

 

 

AUDIOLOGY ASSISTANT

AUTHORIZATION

Forms:

Checklist

Application 

Letters of Agreement 

        

OBESPA MAIL-IN

RENEWAL AND DEACTIVATION FORMS

 2021 Renewal Form

2021 Deactivation Form

 

GENERAL FORMS

  • Academic Preparation and Practicum Verification Form
  • Complaint Form
  • Continuing Education Form and List of Approved CE Activities
  • Non-Accredited Degree Program Practicum Form
  • Non-Accredited Degree Program Preparation Form
  • Reactivation Form
  • Report of Clinical Fellowship
  • Required Reference Letter
  • Verification of Citizenship Affidavit
  • Verifying Qualified Alien Status Affidavit

 

 

 

 

 

 

 

 

   

  

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