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					Administration & Information Wyoming Board of Hearing Aid Specialists
	PLB Home Page Home Page Application Instruction & Forms Board Members Fee Schedule Related Sites Rules and Statutes				APPLICATION INSTRUCTIONS Application Instructions for Hearing Aid Specialists Listing of all Forms Mail Applications To: WYOMING STATE BOARD OF HEARING AID SPECIALISTS 1800 Carey Avenue, 4th Floor Cheyenne, WY 82002 (307)777-6529 APPLICATION INSTRUCTIONS FOR HEARING AID SPECIALISTS WYOMING BOARD OF HEARING AID SPECIALISTS APPLICATION INSTRUCTIONS GENERAL INFORMATION The Board will not review your qualifications without receipt of a formal application and fee. All fees are non-refundable. Payments must be in the form of a certified check or money order made payable to the "State of Wyoming". Do not send a personal or business check. Documents submitted in support of the application must contain an original signature and be submitted directly to the Board from the source where required, not forwarded through you. Application files will be presented to the Board for review when all required documentation has been received. The written examination is generally offered in January, April, July, and October of each year. The practical examination is offered in January and July only. Applications for examination must be received by December 1, March 1, June 1 and September 1 respectively. You should apply well before the examination deadline or be prepared to wait until the next administration of the examination. The Board will review applications for license by endorsement on a case by case basis. The Board retains the right to require an applicant to take any or all portions of the examination even though the applicant may be currently licensed in another jurisdiction. FORMS AND OTHER DOCUMENTATION Application in General Type or print all information clearly. Check the appropriate box under "LICENSURE METHOD". If applying for a temporary permit, check the appropriate box under "REQUEST FOR TEMPORARY PERMIT". If applying for a temporary permit, include a separate cashier's check or money order in the amount of $300.00 with your application in addition to the $200.00 application fee payment. If a temporary permit is approved, the permit will be mailed to you in a timely manner. If it is not approved, your additional fee will be returned. Sign the application in the presence of a notary. Application Form Items #1 through 8 are self-explanatory. Item #9- Indicate registration(s) or license(s) including Wyoming, where you are currently or have been previously registered/licensed in any profession. Begin with your original registration/license. Note carefully any registration/license not currently in good standing. If applying for reciprocal license, contact the licensing board where you are currently registered/licensed as a hearing aid specialist. Request that board to verify your licensure status to the Wyoming board. The verification must include your name, social security number, license number, the date the license was issued, the date the license expires/expired, whether or not there were any disciplinary actions taken against your license, written examination subjects and scores, and practical examination subjects and scores. Item #10- List your educational history. Begin with the highest level of school attended (college or university, high school, GED equivalent.) Include a copy of your high school diploma with your application. Item #11- Indicate persons who have recent knowledge of your integrity, professionalism and character with whom you have had contact within the past five (5) years. Request that these individuals listed provide a letter of reference on your behalf to the Board. These letters should be written on professional letterhead or stationery. The letters must be sent directly to the Board from the reference and not forwarded through you. References must have been written within six (6) months of your application date and will not be accepted from relatives. Item #12- List your training/work experience for the last five (5) years. Begin with your most current training/work experience. Account for all time, even time unemployed. Do not leave gaps in the time sequence. If additional pages are necessary, include your name and social security number on the top of any additional sheets of paper. Items #13-19- If a written explanation is necessary for a "YES" answer to any of items #13-19, include your name and social security number on the top of any additional sheets of paper. Certificate of Sponsorship- This form is required if applying for a temporary permit under supervision. Your sponsor must be a Wyoming licensed Hearing Aid Specialist. Certification of Audiometric Equipment Calibration- This form is required prior to the examination date. You may send it in with your application or bring it with you to the exam. The equipment that you will be using for the practical examination must have been calibrated within one (1) year of the exam date. Attach a copy of the calibration report to this form. Examination The examination consists of two parts: a four (4) hour written test and a practical examination that will last approximately one (1) to two (2) hours. The written portion, provided by the International Hearing Society, contains eleven (11) separate sections covering the following major topic areas: Section 1: Acoustics: General Principles Frequency, Pitch and Tone Quality of Sound Intensity: Loudness of Sound Section II: Acoustics: Hearing and Speech The Human Ear: External, Middle Ear & Inner Ear Section III: The Hearing Process Disorders of Hearing: Conductive Section IV: Disorders of Hearing: Sensorineural, Central & Non-Organic Pure Tone Audiometry: Theory Section V: Pure Tone Audiometry: Air & Bone Construction Section VI: Speech Audiometry The Audiogram Section VII: The Hearing Analysis: The Auditory Area An Introduction to Electronics Section VIII: Hearing Aids: Characteristics & Components Section IX: Hearing Aid Fitting Section X: The Earmold Delivery & Post Fitting Care Section XI: Wyoming Law and the Hearing Aid Specialist Current Rules and Regulations The information contained in the written section is almost exclusively taken from the following sources: 1. Training Manual for Professionals in the Field of Hearing Instrument Sciences provided through the International Hearing Society. 2. Hearing Instrument Science and Fitting Practices , Edited by Robert E. Sandlin, Ph.D. (copyright 1985). 3. Hearing Instrument Counseling: Practical Application for Counseling the Hearing Impaired , Edited by Max Chartrand (copyright 1990). 4. Hearing Instrument: Selection & Evaluation , Edited by Ernest Zelnik (copyright 1987). 5. Masking: Practical Applications of Masking Principles and Procedures , by Linda L. Larson-Donaldson, M.A. (copyright 1988). 6. The Wyoming Hearing Aid Specialists Licensure Act , W.S.33-35-101 through 33-35-121, 1977, Legislature. 7. The Wyoming Hearing Aid Specialists Rules and Regulations , revised May, 1995. The practical examination will require you to obtain a pure tone air conduction & bone conduction hearing evaluation, along with a speech reception threshold, speech discrimination test, most comfortable level and threshold of discomfort. A working knowledge of masking procedures will also be required. Additionally, you will be asked to demonstrate your ability to make an earmold impression. A score of at least 65% on each section of the written examination, with an overall average of 70% on the entire written examination, is required to pass the written examination. An overall score of at least 65% on each section of the practical examination, with an overall average of 70% on the entire practical examination, is required to pass the practical examination. It is IMPORTANT to understand that the examination is comprehensive and covers, in detail , a great many of the aspects of hearing aid selection and fitting. Preparation for the examination is HIGHLY advisable. To obtain the materials please visit the International Hearing Society’s website: www.ihsinfo.org//IhsV2/Store/010_Textbooks/005_Distance_Learning_Package.cfm or call them at (734)-522-7200. PROCEDURE Submit your application and fee to the Board. The Board will acknowledge receipt of your application and fee. When all required documents have been received, the Board will review your application and determine if you are eligible for examination. You will be notified of your eligibility. Specific exam information will be sent to you at least fifteen (15) days prior to the examination. Inquiries regarding these application procedures and application status should be directed to: Contact Information Debra Bridges Executive Director 1800 Carey Avenue, 4th Floor Cheyenne, WY 82002 Phone: (307) 777-6529 Fax: (307) 777-3508 email: debra.bridges@wyo.gov Effective 7/1/99