Delegation Change (SA6)

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


If you are a limited licensee, 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.


This form is for SLPAs (speech-language pathologist assistants), if you are not an SLPA, please double check the form you are submitting and the submission link.


I will review the supervisors for good standing, here are their qualifications:

  • A licensed full-time (35 hours or more a week) speech-language pathologist may not supervise more than the equivalent of two full-time (35 hours or more a week) speech-language pathology assistants.
  • A licensed part-time (less than 35 hours a week) speech-language pathologist may not supervise more than the equivalent of one full-time (35 hours a week) speech-language pathology assistant.


A supervisor in good standing shall:

  • Have a minimum of 3 years work experience (2 years since receipt of full license or ASHA-CCC) as a speech-language pathologist;
  • Maintain on-going contact with all clients seen by a speech-language pathology assistant by participating in:
  • Not less than one session every 2 weeks of in-person contact per client if the client is being seen three times per week or more; or
  • Not less than one session per month of in-person contact per client if the client is being seen two times per week or less;
  • Provide supervision of the speech-language pathology assistant that is a combination of direct on-site activities and indirect activities


Please see the COMAR section about this for more information.


SA6 Form

Select
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Supervisor(s) of limited licensee/SLPA.


Limited Licensees: All proposed supervisors will be checked to ensure they're in good standing. Any supervisors not in good standing will not be approved.

The site(s) where the limited licensee/SLPA will be practicing.

Drag and drop files here or

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


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