Section 682.200  Application Procedures

Applicants for licensure shall submit to the Department the following forms and fees that are required for license application:

a)         Application processing fee - $40;

b)         Application form that requests the following information:

1)         name of applicant, birthdate, sex, home mailing address, home phone number, business or agency name, business mailing address, e-mail address (if available), business phone, preferred mailing address, highest level of education completed, any university attended, educational degrees awarded, professional certificates held, number of years applicant has dispensed hearing instruments, previous convictions or disciplinary actions against the applicant, citizenship status, indication that applicant is free of infectious disease, and Hearing Instrument Consumer Protection Act compliance statement with the signature of applicant;

2)         beginning January 1, 2003, verification of the successful completion of 12 semester hours or 18 quarter hours of academic undergraduate course work in an accredited institution consisting of 3 semester hours of anatomy and physiology of the speech and hearing mechanism, 3 semester hours of hearing science, 3 semester hours of introduction to audiology, and 3 semester hours of aural rehabilitation, or the quarter hour equivalent;

3)         beginning January 1, 2003, official transcripts from an accredited institution of higher education verifying a minimum of an associate degree pursuant to Section 8(e) of the Act;

c)         License Fee - $115 (2 year);

            CFY one-year license fee - $60 (non-renewable);

            Duplicate/Additional License Fee - $10 (each);

d)         Proof of liability insurance that shall give the name and address of the agency; the names and addresses of the applicants insured; the name of the company affording coverage; the type of insurance (malpractice); the policy number; policy expiration date; limits of liability in thousands; any cancellation clauses and the address of the Department as the agency to be notified if the policy is cancelled or expires; and

e)         Applicants for a one-year CFY dispenser license must submit a letter of verification from the CFY supervisor of the CFY term of employment.

(Source:  Amended at 26 Ill. Reg. 11995, effective July 22, 2002)