ADHS Division of Licensing Services
Special License Application Forms
Notice Regarding Application Fees:
A.R.S. § 36-405(C)(1) requires the Department to collect nonrefundable application fees from all health care institutions. All Initial, Renewal, and Change of Ownership applications must include a $50 nonrefundable application fee. The Department will consider any application received without the application fee to be incomplete. (Note: This does not apply to Child Care Licensing.) Checks shall be made payable to the Arizona Department of Health Services.
NOTE: All applications require an Arizona Statement of Citizenship and Alien Status.
- CEU Pre-Approval Forms for CE Providers
- CEU Forms for Licensees
- Licensing Forms
- Initial License Application Speech Language Pathology Assistant
- Initial License Application Speech-Language Pathology & Audiology
- Initial License Application for Individual Hearing Aid Dispenser
- Renewal License Application Speech-Language Pathology Assistant
- Renewal License Application Individual Hearing Aid Dispenser/Audiologist/ Speech-Language Pathology
- Hearing Aid Business License Application
- Clinical Fellowship Agreement
- Temporary Hearing Aid Dispenser Sponsor Form
- Midwife Licensing Application
- Midwife Apprenticeship Form
- DD Group Home Application
- DD Group Home Inspection Checklist
- DD Group Home Fire Inspection
- DD Group Home Vehicle Checklist
- Architectural Review Application
Information provided in PDF files, unless otherwise indicated.