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.
