ABESPA Forms

List of 11 forms on this page: (Scroll down for more instructions.)

1. License Renewal Notice/Application
2. Licensure Application
3. CFY Registration/4th Year Internship
4. End of CFY - Completion of Licensure Application Process
5. License by Reciprocity
6. Request for Grant Monies for Continuing Education Activity
7. Continuing Education Pre-Approval Application
8. Change of Address Request
9. Change of Name Request
10. File a Complaint
11. ABESPA Consumer Guide

Also, Computer Tips

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1. License Renewal Notice/Application

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2. Licensure Application

Common Omissions when Submitting the Licensure Application Form:

* A letter from the director of the educational program verifying that requirements prior to supervised clinical experience have been completed.

* Notarized letter from CFY or 4 th Year Internship Supervisor containing: number of hours per week worked, place of employment, supervisor's name & AL license number or CCC or its equivalent.

* Undergraduate and Graduate Transcripts.

Another common misunderstanding is that there are TWO SEPARATE FEES: an application fee (which is $200), and a licensure fee (which is $75). The application fee is due with the application. The licensure fee may be paid at that same time or paid once the application is approved for licensure.

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3. CFY Registration

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4. End of CFY - Completion of Licensure Application Process

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5. License By Reciprocity

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6. Request for Grant Monies for Continuing Education Activity

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7. Continuing Education Pre-Approval Application

How to Submit Continuing Education Pre-Approvals

Pre-Approval of an upcoming Continuing Education opportunity may be submitted to the ABESPA office at any time. Approvals or disapprovals are decided upon by review and vote of the entire Board. Submitting a request to an individual member results in that member submitting the individual request to the Board as a whole during the regularly scheduled meeting.
(Click here for scheduled Board Meeting Dates.)

The appropriate steps to follow include:

(a) Download the CEU Pre-Approval form and follow the listed instructions.

(b) Submit the following information to the Board:

- Course Objectives
- Biographically Information about the Speaker
- Classification of the Course as Content I or Content II
(Click here for a .pdf copy of the Rules and Regulations.
Or, click here for a .doc copy of the Rules and Regulations.
Then see page 33 of 51.)

(c) Submit the form to:

ABESPA
400 South Union Street, Suite 397
Attn: Wanda Rawlinson, Executive Secretary
PO Box 304760
Montgomery, Alabama 36130-4760

Please note the timeliness required to obtain an answer to the submitted request.
Remember, it is a vote of the Board that determines the status of a CEU request.

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8. Change of Address Request

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9. Change of Name Request

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Information and Instructions for Filing a Complaint:

10. File a Complaint
11. ABESPA Consumer Guide