Please complete the AS2 and upload the form here. Make sure to put hours in all of the columns. The table must be filled out with hours, language like 'as needed' will NOT be accepted.

• Column 1 - Hours spent per week by the limited licensee
• Column 2 - Hours spent observing per month by the supervisor, at least 36 hours required**
• Column 3 - Other monitoring activities of the supervisor, at least 2 hours required

** Part time employment may change these hours

This form is for SLP-LLs (speech-language pathologist limited licensees). You will receive an updated license and cover letter showing the change. This will be mailed shortly after approval and will arrive in approximately 7-10 business days.

If you are not an SLP-LL, please double check the form and submission link you are using.

All supervisors will be checked for good standing, any supervisors that are not in good standing will not be approved. These are the qualifications.

• Hold a current Full License in Speech-Language Pathology (or, if the position is in a setting where licensure is not required, the supervisor shall hold a current CCC-SLP from ASHA.)
• Have been in practice for a minimum of 2 years after completion of the clinical fellowship
• Supervise no more than three limited licensees at one time.
• Not have been formally disciplined by the Board within the previous 5 years.

AS2 Form