2010 LBESPA Printable Renewal Forms
Right-click the file links and select "Save-As" - Then open in Acrobat to fill in the forms.
ONLINE RENEWAL available through "Licensee Login"

License Type

Renewal Form

Supervision Forms
Must be submitted with Renewal Application

Speech-Language Pathologist

Renewal

Provisional/Restricted SLP

Renewal

Supervision Form 100

SLP Assistant

Renewal

Supervision Form 200

Provisional SLP Assistant

Renewal

Supervision Form 200

Audiologist

Renewal

Provisional Audiologist

Renewal

Supervision Form 100

Dual Licensure

Renewal

MISSION STATEMENT:

We exist because the legislature declared that "in order to safeguard the public health, safety, and welfare, to protect the public from incompetent, unscrupulous, and unauthorized persons, and from unprofessional conduct by speech-language pathologists, audiologists, and speech-language pathology assistants, it is necessary to provide regulatory authority over persons offering speech-language pathology and audiology services to the public."