Hearing Instrument Dispenser (HID) Examination Application and Related Documents for Audiologists

Hearing Instrument Dispenser (HID) exam applications are accepted on a first-come, first-served basis. We will accept applications until the exam application deadline or until we have received 25 complete applications. Applications are not considered complete until our office receives the required fee as well as a completed HID exam application.

Please print all 12 documents listed below:

  1. HID Exam Memo (PDF: 140 KB/ 3 pages)
  2. HID Exam Application (PDF: 157 KB/4 pages)
  3. HID Exam Overview (PDF: 21 KB/3 pages)
  4. Bibliography (PDF: 19 KB/4 pages)
  5. Sample Informed Consent Agreement (for your subject's review) (PDF: 21 KB/ 1 page)
  6. MN Stat. § 148.5197 — Hearing Aid Dispensing
  7. MN Stat. § 148.5198 — Restriction on Sale of Hearing Aid
  8. MN Stat. Ch. 153A — Hearing Instrument Dispenser Certification
  9. MN Stat. § 325G.06–325G.14 — Home Solicitation Sales (PDF: 42 KB/6 pages)
  10. MN Stat. § 325G.203–325G.208 — Assistive Device (PDF: 37 KB/5 pages)
  11. FDA Part 801, Sub H: Special Requirements for Specific Devices; § 801.420 — Hearing Aid Devices; Professional and Patient Labeling
  12. FDA Part 801, Sub H: Special Requirements for Specific Devices; § 801.421 — Hearing Aid Devices; Conditions for Sale

Once you have printed and read all 12 documents, please complete the Hearing Instrument Dispenser Examination Application. Mail the completed application with the required fee to the address listed at the top of the application.

If you are unable to print the examination application and forms, please contact Patti Fuller at 651-201-5468 or at Patti.Fuller@state.mn.us.

Updated Wednesday, 12-Feb-2014 11:15:52 CST