Compliance form 2026

1. Click ‘Get Form’ to open the compliance form in the editor.
2. Begin by providing your current and accurate information. Fill in your ASHA ID, name, previous names used (if applicable), address, daytime phone, evening phone, and email.
3. Indicate if this is a new address by checking the appropriate box. Next, check the area(s) of certification that apply to you: CCC-A, CCC-SLP, or Dual.
4. Review the affidavits carefully. Your signature on this form confirms that you agree with all statements regarding accuracy of information and compliance with certification standards.
5. Sign at the bottom of the form and date it appropriately. Ensure all fields are completed before submission.
6. Submit your completed form to ASHA at the provided address: 2200 Research Blvd. #313, Rockville, Maryland 20850.

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