Reinstatement of a Lapsed License

Before applying for licensure, please familiarize yourself with the general licensing policies. 

 

Applications are only accepted online.  In order to submit your reinstatement application online, you will need to know your current user ID and password in DPH's system.  If you do not recall your user ID and password, you can use the recovery options as well as the 'Register' link.  If you use the 'Register' link, please disregard the language under 'PLEASE READ' and select 'NEXT' button at the bottom of the page.  On the next screen, you will need to match your first name, last name and the last 4 digits of your SSN and create a new password and validate your email address.  Please select this link to submit your online application.  The application fee is $200.

 

As part of the online application, you will upload a current curriculum vitae (CV) or synopsis of professional activity since completion of the your educational program and certificates of completion of at least 10 hours of continuing education hours completed within the 1 year period from the date of application for reinstatement. 

The applicant is responsible for the following documents to be submitted to this office directly from the source:

 

Verification from the appropriate authority confirming your most recent employment; including dates and overall evaluation of your ability to practice with reasonable skill and safety;

 

If applicable, verification of any out-of-state license held, current or expired  submitted directly to this office from the source.  Please contact the jurisdiction prior to submission of the form as some may charge a fee for this service.

 

Note:  Typically, applicants for reinstatement who have not been in active, clinical practice for longer than five years are required to complete a period of refresher training.  Applicants to whom this applies will receive further information from the Department upon receipt of all required documentation.

 

All supporting documentation must be submitted from the source to:

 

Connecticut Department of Public Health

Audiologist Licensure

410 Capitol Ave., MS # 12 APP

P.O. Box 340308

Hartford, CT 06134

Phone:  (860) 509-7603

Fax:  (860) 707-1930

Email:  Dph.Hairdresserteam@ct.gov