- Applicants that are applying from another state should send in the application without a check as they will receive a letter stating the amount needed once it is determined whether they need to take an exam or not.
Change of Name or Request for Duplicate License for Board of Registration of Hearing Instrument SpecialistsThis PDF form maybe used to request a name change, address change or a duplicate license.
If you require a certificate of verification to go to another jurisdiction(s), please submit separate verification request forms with applicable fees for each verification requested
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