Temporary License: Renewal
You can renew a temporary license twice.
You will need to start this process 30 days before your temporary license expires.
This application may be used for renewal of a Temporary License for Clinical Fellowship/Doctoral Externship or Persons Credentialed by ASHA, ABA or Other States
INSTRUCTIONS:
- The applicant must complete and sign Part I of the Application and the Waiver and Release form.
- The speech-language pathologist or audiologist that will be your supervisor must complete and sign Part II of the application form.
- Make a copy of the completed forms for your records.
- ALL FEES ARE NON-REFUNDABLE
- Mail the original completed forms to the address on the form with a check or money order for the appropriate fee (see fee schedule) made payable to Treasurer, State of Minnesota.
- Once MDH has received the completed application and fee your money is deposited and the application will be reviewed and processed. This process takes 1-10 business days. Your approval letter and wallet card will be mailed to the designated address listed on your application.
- Any questions please call 651-201-3726 or email gloria.rudolph@state.mn.us
FORMS:
Print application form from link: Temporary License Application Form for Clinical Fellowship and /or Doctorial Externship (PDF:38k/3 pages)
Print application form from link: Temporary License Application Form for Persons Credentialed by ASHA, ABA, or other States (PDF:33k/ 2 pages)
