Download Forms-CISC

Cochlear Implant Specialty Certification

  • Completed Application: Form A
  • Patient and Case Management Hours: Form 1
  • Professional Reference #1: Form 2
  • Professional Reference #2: Form 2
  • Request for Special Examination Accommodations: Form 3
  • Documentation of Disability-Related Needs: Form 4
  • Non-Disclosure Agreement: Form 5 (to be completed on exam day)
  • Demographic Information: Form 6

View the Cochlear Implant Specialty Certification Handbook

Note: If your doctoral degree is not specifically titled “audiology,” contact the ABA offices for the Documentation of Coursework & Practicum Form.