R9-13-110. Hearing Screening Trainer Certificate of Completion

A. An individual who meets the eligibility requirements, as specified in R9-13-109(A), may apply for a hearing screening trainer certificate of completion by submitting a request to the Department, in a Department-provided format, that includes: 1. The individual’s name, address, email address, and telephone number; 2. If the individual is a licensed audiologist, as specified in R9-13-109(A)(1), the: a. Audiologist’s license number, and b. Date of expiration; 3. If the individual is a registered nurse according to A.R.S. Title 32, Chapter 15, as specified in R9-13-109(A)(2), the: a. Registered nurse license number, and b. Date of expiration; 4. If the individual has completed 30-semester credits, as specified in R9-13-109(A)(3), all applicable academic transcripts demonstrating that the qualifying educational requirements have been met; 5. If the individual is a hearing screener who has maintained a hearing screener certificate of completion for the previous five years, as specified in R9-13-109(A)(4), the: a. Names of the school districts where the hearing screener provided hearing screenings, and b. Hearing screener’s certification of completion date of expiration; 6. Whether the individual completed the hearing screenings, as specified in R9-13-109(A)(3); and 7. An attestation that: a. The applicant will comply with the requirements in R9-13-109, and b. The information provided in the request for the hearing screening trainer certificate of completion is true and accurate; and c. The individual’s signature and date of signature. B. Within 30 calendar days after the date the Department receives an individual’s request for a hearing screening trainer certificate of completion, the Department shall send a notification to the individual regarding the information on how the individual may register to take hearing screening classroom instruction and written examination.