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CERTIFICATION MAINTENANCE COMPLIANCE FORM Instructions Print this form Complete all information Sign at the bottom Submit your form via mail or fax ASHA 2200 Research Blvd. 313 Rockville Maryland 20850 301-296-8569 Please provide current accurate information Check here if this is a new address Compliance Interval Check area s of certification ASHA ID CCC-A Name CCC-SLP Dual Previous Name s Used Address Street Daytime Phone City State Zip Evening Phone E-mail Affidavits Your signature on this form affirms that you have read the following statements and agree to abide by each statement 1. I affirm that the information provided on this Compliance form is accurate. 2. I affirm that in accordance with the Certification Standards I have participated in 30 Certification Maintenance Hours of professional development during my 3-year certification maintenance interval. 3. 313 Rockville Maryland 20850 301-296-8569 Please provide current accurate information Check here if this is a new address Co....

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If you are selected for the maintenance audit, you will be required to submit the following documentation to the ASHA National Office: Completed Certification Maintenance Record Keeping Form [PDF] Copy of a certificate of completion for each professional development activity completed.

Every individual who is (a) a member of the American Speech-Language-Hearing Association, whether certified or not, (b) a nonmember holding the Certificate of Clinical Competence from the Association, (c) an applicant for membership or certification, or (d) a Clinical Fellow seeking to fulfill standards for ...

The Code of Ethics reflects what we value as professionals and establishes expectations for our scientific and clinical practice based on principles of duty, accountability, fairness, and responsibility.

The ASHA Code of Ethics reflects professional values and expectations for scientific and clinical practice. It is based on principles of duty, accountability, fairness, and responsibility and is intended to ensure the welfare of the consumer and to protect the reputation and integrity of the professions.

General Information About ASHA Certification Being "certified" means holding the ASHA Certificate of Clinical Competence (CCC), a nationally recognized professional credential that represents a level of excellence in the field of Audiology (CCC-A) or Speech-Language Pathology (CCC-SLP).

Requirements for Maintaining Your CCC Submit your Compliance Form to verify your 30 professional development hours. Abide by the ASHA Code of Ethics. Maintain affiliation by paying annual dues or the annual certification fee.

The Role and Advantages of State Licensure For these reasons, state licensure is essential in ensuring that consumers are protected from incompetent and or unethical practitioners. In contrast, certification is voluntary, and only those individuals who choose to be certified are bound by the ASHA Code of Ethics.

All certificate holders must have a Compliance Form submitted because it verifies all aspects of the certification maintenance requirements, not only the requirement to participate in professional development, but also adherence to the ASHA Code of Ethics and payment of annual dues.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232