THESE ARE LINKS TO THE NEW REQUIRED FORMS AND APPLICATIONS NECESSARY TO APPLY AND BE LICENSED BY THE HEARING INSTRUMENT DEALERS BOARD. THESE FORMS ARE EFFECTIVE AS OF AUGUST 2016 AND WILL BE THE ONLY FORMS ACCEPTED. PLEASE COPY, COMPLETE AND SUBMIT BY U.S. MAIL WITH ORIGINAL SIGNATURES BY THE APPROPRIATE DATES.
APPLICATION FOR EXAMINATION FORM:
CITIZENSHIP REQUIREMENT FORM:
WORK HISTORY / EDUCATION FORM:
VERIFICATION OF LICENSURE FORM 2016:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
APPLICATION FOR APPRENTICE PERMIT:
APPLICATION FOR HEARING AID SPECIALIST LICENSE (formerly Fitter's License):
APPLICATION FOR HEARING AID DISPENSER LICENSE:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
LICENSE RENEWAL FORM (Must be submitted no later than Jan 30th of each year):
DUPLICATE LICENSE FORM:
STATEMENT OF BUSINESS COMPLIANCE PACKET:
COMPLAINT FORMS: Currently, HIDB requires that all Complaints be submitted to our office by U.S.Postal Service. Complaint must be in letter format and signed by Complainant. Complaint should contain your full name, address, telephone number and a full description, including names, dates, locations, etc. of the incident or issue for which you are submitting the registered complaint. Anonymous complaints will not be considered nor receive a response. If you are concerned about an advertisement or publication the original paper must be submitted, no copies of ads.
*THE COMMENT / CONTACT PAGE CANNOT BE USED TO SUBMIT FORMAL COMPLAINTS. ALSO, COMPLAINTS SENT DIRECTLY TO BOARD MEMBERS WILL CAUSE THEM TO MANDATORILY RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON SAID COMPLAINT.
Print, Complete and Submit the Original Forms by Mail* to the following address:
HEARING INSTRUMENT DEALERS BOARD
400 SO. UNION STREET, SUITE 235 B,
MONTGOMERY, AL 36104-4361
*NOTE: All Applications and Forms must be postmarked by the due date to be accepted and considered delivered on time. If not received or postmarked by the due date such forms and licenses and permits will be subject to late fees.
Should you have any questions about any form or procedure for licensing or renewal, Please contact Marilyn Fletcher at (334) 593-3777 or firstname.lastname@example.org