Delegation Agreement (AUD-A6)

Please complete the SA6 form and upload below. Please fill out all required fields and any other fields to the best of your knowledge.


An Audiology Assistant or an applicant for licensure as an Audiology Assistant must file a Delegation Agreement with the Board. A separate agreement must be filed for each supervising Audiologist under whom the AUD Assistant will be working. Each Delegation Agreement must be re-filed at the time of license renewal. Additionally, if there is a change of supervision (adding or removing), a new Delegation Agreement must be filed immediately.


Please see the COMAR section about this for more information.


AUDA 6 Form

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Supervisor(s) of AUD Assistant



The site(s) where the limited licensee/AUD-A will be practicing.

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If you would like to indicate special instructions like removing a supervisor, etc., please indicate it here.

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