ADHS Licensing Complaint Submittal Form

Online Complaint Submittal Form - Special Licensing

The Division of Licensing Services, Bureau of Special Licensing provides this Online Complaint Form which allows anyone with knowledge or concerns about a suspected rule violation to submit a complaint through this web page. A complaint is a suspected violation of Arizona state rules and/or statutes governing the licensed practices of audiologists, speech-language pathologists, speech-language pathology assistants, hearing aid dispensers, and hearing aid dispensing businesses.

The Bureau of Special Licensing has the authority to investigate complaints related to suspected violations of the statutes (Arizona Revised statutes Title 36, Chapter 17) and rules (Arizona Administrative Code Title 9, Chapter 16, Articles 2 and 3) that govern the licensure of speech and hearing professionals.

Please review the following prior to submitting the complaint allegation.

Complaint Frequently Asked Questions (FAQs)

When filling out this form, information that is required is indicated by a red asterisk (*). Click "Start" to begin complaint.