Change of Address

Please provide the Board Examiners for Hearing Instrument Specialists with any change in your business and/or home address. Please use the form below to report address changes and/or remove address(es) from your record and click submit.

Only the licensee should change information on this site. By entering information on this site, you are representing that you are the person whose information is being changed.

Name as it appears on your license
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New/Current Business Address

New/Current Home Address

Old Business Address

Old Home Address

Updated copy of your license