FORMS
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.
NOTE: JANUARY 2025 EVERYONE WILL SUBMIT THEIR YEARLY LICENSE RENEWAL APPLICATION AND fees.
the next CEU REPORTING period WILL BE JANUARY 2026, WHICH WILL INCLUDE TWENTY (20) total CEU HOURS, OF WHICH SIX (6) will be the mandatory directed hours in patient care. medical and law & ethics, in addition to required fees and documents.
|
2025 LICENSE RENEWAL FORMS DOWNLOAD
DUE JANUARY 30, 2025 (License Renewal Form must be received no later than Jan 30th of each year) |
PLEASE DOWNLOAD, PRINT, REVIEW ALL INSTRUCTIONS IN RENEWAL MEMO AND SUBMIT WITH APPLICABLE FEES BY DUE DATE:
NEW 2025 FORMS |
|
|
| ||
| work_history___education_form.pdf |
| application_for_apprentice_permit.pdf |
| application_for_hearing_aid_specialist_license.pdf |
| application_for_hearing_aid_dispenser_license.pdf |
| duplicate_certificate_request_form.pdf |
| verification_of_licensure_form.pdf |
| hidb_compliance_statement_packet.pdf |
| updated_complaint_form__1_.pdf |
Note: Each party to a complaint will be kept informed throughout the complaint process as the HIDB seeks resolutions that are beneficial to all parties involved. Any illegal acts from either party to a complaint will be forwarded to the Attorney General's Office. Be aware that anonymous complaints will not receive any consideration of the HIDB.
If you are concerned about a printed advertisement or publication the original paper must be submitted, no copies of ads. Online or Social Media ads / issues will require saved screenshots to be forwarded to the Board office in conjunction to the complaint.
Print, Complete and Submit the Original Forms by Mail* to the address at the top of the form.
*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
Should you have any questions about any form or procedure for licensing or renewal, Please contact the Board Executive Secretary, Sandra Bice, at
(334) 593-3777 or hidb@att.net
If you are concerned about a printed advertisement or publication the original paper must be submitted, no copies of ads. Online or Social Media ads / issues will require saved screenshots to be forwarded to the Board office in conjunction to the complaint.
Print, Complete and Submit the Original Forms by Mail* to the address at the top of the form.
*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
Should you have any questions about any form or procedure for licensing or renewal, Please contact the Board Executive Secretary, Sandra Bice, at
(334) 593-3777 or hidb@att.net