Licensee Forms

• Request for Replacement License
• Application to Supervise a Trainee
• Branch Office Application
• Change of Address Request
• Delinquent License Renewal
• Inactive License Application
• License Renewal
• Notification of Name Change
• Request for License Verification
• Official License Certification/Letter of Good Standing

If the form you are looking for is not listed, email your request to us at hearingaid@dca.ca.gov.
Remember to provide your mailing address and telephone number.

Note: These forms are designed so they can be filled in on-line and then printed for mailing. To begin filling in the form, point your mouse to the box you wish to enter information and click the mouse button. The tab key can be used to jump from box to box. For those boxes needing a checkmark, position the mouse in the box and click your mouse button. A checkmark will be entered for you. When you have competed entering the information into the form, it is ready to be printed and mailed to the address indicated on the form.