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Florida Hearing Instrument Specialist — Requirements & Free Practice

US-FL · License preparation

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Hearing Aid Specialist

Florida license for dispensing prescription hearing aids. Active, inactive, retired, renewal and restoration pathways are recorded under this license identity.

Licensing authority: Florida Board of Hearing Aid Specialists / Florida Department of Health · Application information

Maintenance of good standing during qualifying active military service
No examination is required for this applicant pathway.
Duration
Good standing continues without registration, fees or other acts during active duty and six months after discharge.
Eligibility
The licensee was in good standing and entitled to practice when entering active duty and is not practicing privately for profit.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal of an active license
No examination is required for this applicant pathway.
Background screening
Complete mandatory background screening or retain current fingerprints as the Board renewal page directs.
Continuing education
Complete and certify 20 approved hours per biennium, 10 in person and 10 permitted as self-paced, with the required laws and rules, HIV/AIDS and medical-error content under Rule 64B6-5.001. The rule exempts initial licensees from CE credits for the first renewal; the Board page still directs a two-hour medical-error course for every renewal under general law.
Equipment certification
Maintain applicable testing-room and annual audiometric-equipment calibration certifications as required by s. 484.047(2).
Renewal
Submit the renewal application and required fees; licenses renew by February 28 of odd-numbered years.

Official no-examination sources

Effective from 2026-09-22.

Restoration of a delinquent license within the current licensure cycle
No examination is required for this applicant pathway.
Application
Affirmatively apply for renewal, inactive status or retired status before the delinquent cycle ends.
Continuing education
Demonstrate the required CE for an active renewal; a license not restored before the cycle expires becomes null and void.
Fees
Pay the applicable renewal or status fee, delinquency fee and processing fee.

Official no-examination sources

Effective from 2026-09-22.

Reissuance after compliance with a disciplinary final order
No examination is required for this applicant pathway.
Board certification
The Board must certify compliance with every term and condition in the final order; the statute does not prescribe a uniform examination for this restoration route.
Individual order
The applicant must satisfy the actual final order. Case-specific conditions are not assumed to identify an additional currently offered examination.

Official no-examination sources

Effective from 2026-09-22.

Regaining licensure after the specified July 2009–June 2012 renewal denial
No examination is required for this applicant pathway.
Denial period
The applicant was denied renewal under s. 24, chapter 2009-223, Laws of Florida, between July 1, 2009 and June 30, 2012.
Initial requirements
Meet initial-license qualifications and application requirements, with the express s. 456.036(14) exception that the applicant need not retake and pass the initial-licensure examinations.

Official no-examination sources

Effective from 2026-09-22.

Election of inactive license status
No examination is required for this applicant pathway.
Application
File the completed application and applicable inactive-status and status-change fees.
Practice
Do not practice under an inactive license.

Official no-examination sources

Effective from 2026-09-22.

Reactivation of an inactive hearing aid specialist license
No examination is required for this applicant pathway.
Board competency statement
The Board page states: "A licensee who remains on inactive status for more than two consecutive biennial licensure cycles and who wishes to reactivate the license may be required to demonstrate the competency to resume active practice by sitting for a special purpose examination or by completing other reactivation requirements." The current reactivation rule specifies fees and CE; the page does not identify a currently offered examination. Ask the Board for individualized reactivation requirements.
Continuing education
Provide proof of ten approved CE hours for each inactive year under Rule 64B6-3.004.
Fees
Pay the reactivation and applicable processing fees.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal of an inactive license
No examination is required for this applicant pathway.
Practice
Inactive renewal does not authorize dispensing practice.
Renewal
Renew the inactive license biennially and pay the inactive renewal fee.

Official no-examination sources

Effective from 2026-09-22.

Licensure by examination after Florida training
Age
Be at least 18 years old.
Application
Submit the prescribed application and required fees; Rule 64B6-2.003 states application at least 120 days before the examination date.
Background screening
Submit to background screening under s. 456.0135, F.S.
Board certification alternative
The Board page states: "Has an active certification from the National Board for Certification in Hearing Instrument Sciences (NBC-HIS)" as an examination method alternative. The current rule names ILE or NCE; these registered examinations remain alternatives, and a currently certified applicant supplies certification as the Board instructs rather than assuming a new examination sitting is necessary.
Character
Be of good moral character.
Education
Graduate from an accredited high school or its equivalent.
Florida laws course
Complete a two-hour Florida Laws and Rules course taught by a Board-approved instructor covering Chapter 484, Part II, Chapter 456, F.S., and Division 64B6, F.A.C.; Rule 64B6-2.003(2) specifies course completion.
Home study final examination
Pass the International Hearing Society Home Study Course final examination during Stage I and submit proof before Stage II. The current Board page calls it the distance learning course final examination. No supplied nationwide version registers this examination.
Initial issuance
After eligibility certification, submit Form DH-MQA 1156 and the initial licensure fee and meet the minimal procedures and equipment requirements of Chapter 64B6-6, F.A.C., within 90 days or eligibility becomes null and void.
Licensure exam timing
Take the licensing examination within 30 days of receiving the vendor eligibility notice. A passing trainee may continue under supervision in Stage IV until licensed or for 90 days, whichever occurs first.
Qualifying method
Complete the Florida sponsored training program under Rule 64B6-8.003: at least six months, Stage I home-study course, then stages II, III and IV of one, two and three months; after Stage I, at least 20 hours weekly under direct supervision.
Sponsor report
The sponsor must file a complete report of hours, subjects and objectives within 30 days of completion or termination; the report is required for examination eligibility.
Licensure by examination qualification through current NBC HIS certification and twelve months of practice
Active practice proof
Provide the signed sales receipts or accepted employer documentation of active practice.
Age
Be at least 18 years old.
Application
Submit the prescribed application and required fees; Rule 64B6-2.003 states application at least 120 days before the examination date.
Background screening
Submit to background screening under s. 456.0135, F.S.
Board certification alternative
The Board page states: "Has an active certification from the National Board for Certification in Hearing Instrument Sciences (NBC-HIS)" as an examination method alternative. The current rule names ILE or NCE; these registered examinations remain alternatives, and a currently certified applicant supplies certification as the Board instructs rather than assuming a new examination sitting is necessary.
Certification verification
Request that NBC-HIS send proof of current certification directly to the Board. Certification is an applicant condition; the source names NCE in the examination rule and current certification as the Board page alternative to a new examination sitting.
Character
Be of good moral character.
Education
Graduate from an accredited high school or its equivalent.
Florida laws course
Complete a two-hour Florida Laws and Rules course taught by a Board-approved instructor covering Chapter 484, Part II, Chapter 456, F.S., and Division 64B6, F.A.C.; Rule 64B6-2.003(2) specifies course completion.
Initial issuance
After eligibility certification, submit Form DH-MQA 1156 and the initial licensure fee and meet the minimal procedures and equipment requirements of Chapter 64B6-6, F.A.C., within 90 days or eligibility becomes null and void.
Qualifying method
Hold current National Board for Certification in Hearing Instrument Sciences certification and have actively practiced for at least 12 months.
Licensure by examination with an existing hearing aid specialist license and twelve months of practice
Active practice proof
Provide at least two signed sales receipts per month for at least 12 months with place-of-business addresses, or the employer statement accepted by the Board page when receipts are unavailable.
Age
Be at least 18 years old.
Application
Submit the prescribed application and required fees; Rule 64B6-2.003 states application at least 120 days before the examination date.
Background screening
Submit to background screening under s. 456.0135, F.S.
Board certification alternative
The Board page states: "Has an active certification from the National Board for Certification in Hearing Instrument Sciences (NBC-HIS)" as an examination method alternative. The current rule names ILE or NCE; these registered examinations remain alternatives, and a currently certified applicant supplies certification as the Board instructs rather than assuming a new examination sitting is necessary.
Character
Be of good moral character.
Education
Graduate from an accredited high school or its equivalent.
Florida laws course
Complete a two-hour Florida Laws and Rules course taught by a Board-approved instructor covering Chapter 484, Part II, Chapter 456, F.S., and Division 64B6, F.A.C.; Rule 64B6-2.003(2) specifies course completion.
Initial issuance
After eligibility certification, submit Form DH-MQA 1156 and the initial licensure fee and meet the minimal procedures and equipment requirements of Chapter 64B6-6, F.A.C., within 90 days or eligibility becomes null and void.
License verification
Supply license verification from issuing authorities, including disciplinary history, as the Board application directs.
Qualifying method
Hold a valid current hearing aid specialist or equivalent license issued outside Florida and have actively practiced for at least 12 months.
Score timing
An already-passed ILE remains a currently offered examination involved in this route; proof may be transferred from IHS rather than requiring another sitting.
Military health care practitioner or active duty military spouse licensure with an existing United States license
No examination is required for this applicant pathway.
Application
Submit the prescribed military or military-spouse application. The current statute controls; Rule 64B-9.005 retains an older subsection citation in its form-adoption text.
Background screening
Submit fingerprints for required background screening.
Discharge
Military applicants must provide proof of an honorable discharge within six months before application or a forthcoming honorable discharge.
Discipline
Attest to no pending disciplinary proceeding and meet the applicable no-discipline criteria; the department verifies the National Practitioner Data Bank.
Eligibility
Meet s. 456.024(4)(a): qualifying military health care service or qualifying active-duty military spouse status.
Existing license
Hold an active unencumbered license from another United States jurisdiction and have no disciplinary action during the preceding five years under s. 456.024(4)(b)3.a. This alternative requires the existing license rather than a new or prior national-examination score.
Fees
The statute waives application, licensure and unlicensed-activity fees for eligible applicants.
Practice
Have actively practiced the profession for the three years immediately before application.

Official no-examination sources

Effective from 2026-09-22.

Professional licensure of an active duty military spouse assigned to Florida
No examination is required for this applicant pathway.
Eligibility
Otherwise be entitled to full licensure and eligible to take the Florida licensure examination; s. 456.024(5)(a)5 requires eligibility, not an examination passing score for this pathway.
Existing license
Hold a valid professional license from another United States jurisdiction, with no pending disciplinary proceeding.
Ineligibility
Apply the criminal-history, prior license suspension or revocation, National Practitioner Data Bank and previous failed-Florida-examination exclusions in s. 456.024(5)(g).
Older rule
Rule 64B-9.003 still describes a 12-month temporary license on its older form. The controlling current s. 456.024(5) directs a professional license and waives its application fee; the older temporary duration is not emitted as a separate currently created credential.
Screening
Submit fingerprints and pass the required criminal-history screening; pay fingerprint-processing costs.
Spouse
Be married to an active-duty Armed Forces member assigned to a Florida duty station by official orders.

Official no-examination sources

Effective from 2026-09-22.

Renewal exemption during absence for an Armed Forces spouse assignment
No examination is required for this applicant pathway.
Eligibility
The licensee was in good standing and entitled to practice when absence became necessary because of the spouse military duties.
Exemption
Provide satisfactory proof of absence and military status; renewal exemption lasts during the absence and for three months after return to Florida.

Official no-examination sources

Effective from 2026-09-22.

Active duty military spouse licensure through equivalent professional training
Application
Submit the prescribed military or military-spouse application. The current statute controls; Rule 64B-9.005 retains an older subsection citation in its form-adoption text.
Background screening
Submit fingerprints for required background screening.
Discharge
Military applicants must provide proof of an honorable discharge within six months before application or a forthcoming honorable discharge.
Discipline
Attest to no pending disciplinary proceeding and meet the applicable no-discipline criteria; the department verifies the National Practitioner Data Bank.
Eligibility
Meet s. 456.024(4)(a): qualifying military health care service or qualifying active-duty military spouse status.
Fees
The statute waives application, licensure and unlicensed-activity fees for eligible applicants.
National examination
The statute requires a passing score on the appropriate national or regional standards examination when required for Florida licensure. Section 484.045 and Rule 64B6-2.003 identify the currently registered Florida hearing-aid licensing alternatives as ILE or NCE. Prior passing scores remain examinations in the requirement.
Practice
Have actively practiced the profession for the three years immediately before application.
Qualification
Be a health care practitioner spouse in a profession not requiring licensure in the other jurisdiction; submit substantially equivalent training or experience under s. 456.024(4)(b)3.c.
Military health care practitioner licensure through equivalent military training
Application
Submit the prescribed military or military-spouse application. The current statute controls; Rule 64B-9.005 retains an older subsection citation in its form-adoption text.
Background screening
Submit fingerprints for required background screening.
Discharge
Military applicants must provide proof of an honorable discharge within six months before application or a forthcoming honorable discharge.
Discipline
Attest to no pending disciplinary proceeding and meet the applicable no-discipline criteria; the department verifies the National Practitioner Data Bank.
Eligibility
Meet s. 456.024(4)(a): qualifying military health care service or qualifying active-duty military spouse status.
Fees
The statute waives application, licensure and unlicensed-activity fees for eligible applicants.
National examination
The statute requires a passing score on the appropriate national or regional standards examination when required for Florida licensure. Section 484.045 and Rule 64B6-2.003 identify the currently registered Florida hearing-aid licensing alternatives as ILE or NCE. Prior passing scores remain examinations in the requirement.
Practice
Have actively practiced the profession for the three years immediately before application.
Qualification
Be a military health care practitioner whose profession does not require jurisdictional licensure for military practice; submit substantially equivalent military training or experience under s. 456.024(4)(b)3.b.
MOBILE interstate licensure endorsement
International Licensing Examination for Hearing Healthcare Professionals
Application
Submit the MOBILE application and required documentation and fees. The rule incorporates the July 2025 form, while the current Board-hosted application is marked August 2025.
Background screening
Submit fingerprints for the required s. 456.0135 background screening.
Discipline
No pending disciplinary proceeding and no disciplinary action in the preceding five years; comply with the complaint, criminal-history, revocation/suspension, surrender and National Practitioner Data Bank ineligibility provisions of s. 456.0145(2)(c). A successfully appealed report or conduct not violating Florida law is considered as the statute provides.
Existing license
Hold an active unencumbered license in a similar scope of practice issued by another United States jurisdiction.
National certification alternative
A current NBC-HIS certification is accepted instead of an ILE passing score; obtain verification directly from NBC-HIS. The MOBILE implementing page names ILE and certification, and does not separately identify NCE for this pathway.
Practice
Have practiced this profession for at least two years in the four years before application.
Score verification
Obtain proof of the already-passed ILE directly from IHS; passing before application does not remove the registered examination from the requirement.
State law exam permission
Section 456.0145(3) permits a state jurisprudential examination if the applicable law requires one. The hearing aid specialist examination rule implements state-law knowledge through a two-hour course; no separate examination is specified in the current hearing aid examination rule.
New licensure after a license became null and void
Age
Be at least 18 years old.
Application
Submit the prescribed application and required fees; Rule 64B6-2.003 states application at least 120 days before the examination date.
Background screening
Submit to background screening under s. 456.0135, F.S.
Board certification alternative
The Board page states: "Has an active certification from the National Board for Certification in Hearing Instrument Sciences (NBC-HIS)" as an examination method alternative. The current rule names ILE or NCE; these registered examinations remain alternatives, and a currently certified applicant supplies certification as the Board instructs rather than assuming a new examination sitting is necessary.
Character
Be of good moral character.
Education
Graduate from an accredited high school or its equivalent.
Florida laws course
Complete a two-hour Florida Laws and Rules course taught by a Board-approved instructor covering Chapter 484, Part II, Chapter 456, F.S., and Division 64B6, F.A.C.; Rule 64B6-2.003(2) specifies course completion.
Initial issuance
After eligibility certification, submit Form DH-MQA 1156 and the initial licensure fee and meet the minimal procedures and equipment requirements of Chapter 64B6-6, F.A.C., within 90 days or eligibility becomes null and void.
Prior license
The prior delinquent license was not restored within its cycle and became null; apply anew and satisfy all new-license requirements.
Qualifying method
Meet one of the current s. 484.045(2)(f) qualification alternatives: Florida training, current outside license and twelve months of practice, or NBC-HIS certification and twelve months of practice. Training applicants must also satisfy Rule 64B6-8.003, including its course final examination; those training obligations are recorded in the separate Florida-training route.
Reexamination after an unsuccessful licensing examination
Eligibility
Previously failed the licensure examination; submit the completed application and application fee under Rule 64B6-2.003.
Practice restriction
Do not perform dispensing services after failing to sit for or pass the next available examination except as authorized by Rule 64B6-8.003(6).
Unchanged qualification
Meet the applicable s. 484.045 applicant qualifications; this retry route does not confer permission to practice before licensure.
Regaining licensure after denial of renewal under s. 456.0635(3)
Age
Be at least 18 years old.
Application
Submit the prescribed application and required fees; Rule 64B6-2.003 states application at least 120 days before the examination date.
Background screening
Submit to background screening under s. 456.0135, F.S.
Board certification alternative
The Board page states: "Has an active certification from the National Board for Certification in Hearing Instrument Sciences (NBC-HIS)" as an examination method alternative. The current rule names ILE or NCE; these registered examinations remain alternatives, and a currently certified applicant supplies certification as the Board instructs rather than assuming a new examination sitting is necessary.
Character
Be of good moral character.
Denial
Meet the qualifications and application process for initial licensure after denial of renewal under s. 456.0635(3).
Education
Graduate from an accredited high school or its equivalent.
Florida laws course
Complete a two-hour Florida Laws and Rules course taught by a Board-approved instructor covering Chapter 484, Part II, Chapter 456, F.S., and Division 64B6, F.A.C.; Rule 64B6-2.003(2) specifies course completion.
Initial issuance
After eligibility certification, submit Form DH-MQA 1156 and the initial licensure fee and meet the minimal procedures and equipment requirements of Chapter 64B6-6, F.A.C., within 90 days or eligibility becomes null and void.
Qualification
Meet the appropriate s. 484.045 training or prior-license/certification qualification. The historical July 2009–June 2012 statutory examination waiver is recorded in a separate route.
Election of retired license status
No examination is required for this applicant pathway.
Fees
Pay the retired-status fee and, when applicable, the status-change fee under s. 456.036(4)(b).
Practice
A retired-status license does not authorize practice under s. 456.036(1).

Official no-examination sources

Effective from 2026-09-22.

Reactivation from retired status
No examination is required for this applicant pathway.
Continuing education
Meet active-license CE requirements for every retired biennium and pay the applicable renewal and reactivation fees.
Individual requirements
Contact the Board for individualized requirements. Section 456.036(10) permits reasonable competency conditions, including full reexamination, after more than five years retired or without active practice; it identifies no particular examination, and the Board current instructions specify fees and CE rather than naming an examination.

Official no-examination sources

Effective from 2026-09-22.

Hearing Aid Specialist Training Program Registration

Supervised training registration, including Department temporary certification pending the next Board meeting and the stages and continuation authorized by the training rules.

Licensing authority: Florida Board of Hearing Aid Specialists / Florida Department of Health · Application information

One time repeat of the training program after a failed licensing examination
Continuation
If no continuation request was submitted within ten days of the result, repeat the training program once by meeting Rule 64B6-8.002 and take the next available licensing examination.
Course final
Rule 64B6-8.003(1)(a) expressly states that a trainee who passed the home-study final but failed the licensing examination need not repeat the home-study course before the next licensing examination. This continuation concerns the licensing reexamination.
Prior result
Stop functioning as a trainee immediately on receipt of a failed licensing result.
Termination
Failure to sit for or pass the next qualifying scheduled examination terminates trainee dispensing authority within seven days of posted results; further licensure-examination applications remain possible.
Supervised trainee registration and progression to the licensing examination
Entry
Secure an eligible sponsor, file Form DH-MQA 1158 and pay the registration fee. Prior violations of Chapter 484, Part II require a Board determination of eligibility; the Department temporarily certifies eligible applicants until the next Board meeting.
Home study final examination
Pass the IHS Home Study Course final examination during Stage I before Stage II; the current Board page calls it the Distance Learning Course final examination. Neither supplied national version registers this separate course final.
Post exam
Take the licensure examination within 30 days of vendor eligibility notice. After passing, practice only under sponsor supervision until licensed or 90 days, whichever comes first.
Report
The sponsor files the complete report within 30 days after completion or termination; incomplete reporting prevents dispensing and examination eligibility.
Screening
Complete the required background screening as the current Board registration instructions direct.
Supervision
Observe the four-stage progression, at least 20 hours weekly after Stage I and the required direct supervision. In Stage II the supervisor remains in the same room for tests and impressions; in Stage IV the supervisor remains in the same room for delivery and signs the receipt.
Timing
The licensing examination is not a prerequisite to initial registration: it is required after the six-month training program under Rule 64B6-8.003(5). It is included because this registered pathway involves that currently offered examination after registration.
Transfer of a registered trainee to another eligible sponsor
No examination is required for this applicant pathway.
Credit
Credit for completed stages transfers at Board discretion; this sponsor-change approval imposes no additional examination.
Limit
The Department may approve two transfers; additional transfer requires exceptional circumstances and Board approval.
Timing
Transfer before completing the training program at the request of the sponsor or trainee; the Board ratifies the transfer at its next meeting.

Official no-examination sources

Effective from 2026-09-22.

One time continuation in Stage IV after failing the licensing examination
Continuation
Within ten days of receiving the failed result, submit Form DH-MQA 1160 and take the next available licensing examination.
Course final
Rule 64B6-8.003(1)(a) expressly states that a trainee who passed the home-study final but failed the licensing examination need not repeat the home-study course before the next licensing examination. This continuation concerns the licensing reexamination.
Prior result
Stop functioning as a trainee immediately on receipt of a failed licensing result.
Termination
Failure to sit for or pass the next qualifying scheduled examination terminates trainee dispensing authority within seven days of posted results; further licensure-examination applications remain possible.

International Licensing Examination for Hearing Healthcare Professionals

Provider
International Hearing Society (IHS); scheduled and paid through the TestWise system at testing centers
Format
Practice-based computer-delivered multiple-choice examination; most questions present a scenario; a few questions require selecting two (or three) correct answers to earn one point; dichotomous right/wrong scoring
Exam questions
105 multiple-choice questions: 80 scored and 25 unscored pilot questions
Time limit
120 minutes (two hours)
Passing score
Pass/Fail on the overall raw score against the IHS-recommended passing score; the licensing agency makes the final decision
Exam fee
$260.00 (USD) per examination appointment, including re-takes, plus applicable taxes
Examination outline
  • Domain 1. Conduct Patient/Client Assessment (21%) (21%)
    • Objective 1.1 Apply infection control protocols (5%). Includes but is not limited to choosing appropriate infection control processes for tools and equipment; observing universal precautions for infection control; distinguishing between single- and multiple-use items; differentiating among sanitization, disinfection and sterilization processes; and identifying personal protective equipment.
    • Objective 1.2 Apply otoscopic inspection protocols (5%). Includes but is not limited to observing safety protocols during otoscopy; identifying anatomical structures; identifying abnormalities through otoscopic inspection; and recognizing the presence of referral criteria. This objective helps provide evidence of the candidate’s ability to perform otoscopy.
    • Objective 1.3 Utilize audiometric testing protocols (11%). Includes but is not limited to performing air and bone conduction threshold and suprathreshold testing; performing speech audiometry; performing effective masking; and applying principles to include interpreting results of tympanometry/immittance audiometry. This objective helps provide evidence of the candidate’s ability to perform audiometric testing and application of tympanometry.
  • Domain 2. Interpret and Apply Assessment Results (22%) (22%)
    • Objective 2.1 Interpret and explain audiometric results (11%). Includes but is not limited to demonstrating an understanding of referral criteria; interpreting pure tone and speech testing results; identifying the need for additional testing; identifying the degree and configuration of hearing loss; and identifying the type of hearing loss.
    • Objective 2.2 Determine candidacy for amplification (11%). Includes but is not limited to interpreting the case history and outlining contraindications to hearing instrument use.
  • Domain 3. Select Hearing Devices (18%) (18%)
    • Objective 3.1 Select style and type of hearing instruments (9%). Includes but is not limited to establishing fitting goals and selecting specific hearing instruments based on test results, case history, and individual patient/client preferences and lifestyle; selecting electroacoustic and physical properties; and evaluating the need for accessory devices.
    • Objective 3.2 Select earmold or other acoustic coupler (9%). Includes but is not limited to assessing physical properties of the outer ear, taking ear impressions, critiquing ear impressions, and selecting coupler based on patient/client needs.
  • Domain 4. Fit and Dispense Hearing Devices (20%) (20%)
    • Objective 4.1 Utilize protocols to fit hearing instruments and other devices (10%). Includes but is not limited to confirming physical and acoustic integrity of hearing devices; programming and adjusting hearing devices; verifying physical fit and acoustic comfort; orienting patient/client to hearing instruments; and orienting patient/client to assistive devices. This objective helps provide evidence of the candidate’s ability to program and dispense hearing instruments and other devices.
    • Objective 4.2 Verify fitting (5%). Includes but is not limited to selecting verification method based on patient/client; assessing physical and acoustic integrity of hearing devices; interpreting and explaining verification results; and modifying physical and acoustic parameters of device. This objective helps provide evidence of the candidate’s ability to perform fitting verification (e.g., speech mapping, REM).
    • Objective 4.3 Validate fitting (5%). Includes but is not limited to selecting validation method based on patient/client; interpreting and explaining validation results; and modifying physical and acoustic parameters of device. This objective helps provide evidence of the candidate’s ability to perform fitting validation (e.g., questionnaire, self-assessment).
  • Domain 5. Provide Continuing Care (19%) (19%)
    • Objective 5.1 Implement aural rehabilitation and counseling (8%). Includes but is not limited to demonstrating an understanding of the psychology of the hearing impaired; defining and managing patient/client expectations for improved communication; defining and managing family/caregiver expectations for improved communication; and identifying communication strategies.
    • Objective 5.2 Apply instrument maintenance and troubleshooting protocols (9%). Includes but is not limited to employing hearing instrument cleaning procedures; performing listening checks on hearing instruments; troubleshooting acoustic properties of hearing instruments; and adjusting based upon changes in patient/client hearing loss and/or listening needs. This objective helps provide evidence of the candidate’s ability to maintain and troubleshoot instrument performance.
    • Objective 5.3 Interpret electroacoustic analysis results (2%). Includes but is not limited to identifying need for electroacoustic analysis and comparing electroacoustic analysis of patient’s/client’s hearing instruments to fitting specifications.
Examination sources

National Competency Exam (NBC-HIS)

Provider
National Board for Certification in Hearing Instrument Sciences (NBC-HIS); scheduled through Kryterion Webassessor at testing centers
Format
Computer-based multiple-choice board certification examination for holders of a current dispensing license or certificate of registration (where applicable); items from the five competency areas are randomly distributed and scored as a single exam, each item correct or incorrect with no partial credit
Exam questions
100 scored multiple-choice items, sometimes with as many as 30 additional non-scored beta items
Time limit
105 minutes for the 100-question exam; adjusted automatically when beta questions are added
Passing score
Criterion-referenced passing standard set by a modified Angoff methodology; pass or fail reported for the entire exam
Exam fee
$225 (USD) for United States & Canada or $250 (USD) for International, per exam sitting
Examination outline
  • DOMAIN 1: Assess patient presenting problem and needs (25%) (25%)
    • 1) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes a family history of hearing loss.
    • 2) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes childhood hearing-related illnesses.
    • 3) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes hearing loss duration, dizziness, loss of balance, and/or tinnitus.
    • 4) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes hearing loss duration, trauma and/or discomfort.
    • 5) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes past and/or current health conditions and/or medication/drug history.
    • 6) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes occupations or recreational activities that include exposure to noise and acoustic trauma.
    • 7) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario including history of ear surgeries, diseases and treatments.
    • 8) Identify the potential impact on patient's lifestyle (e.g., family, work, social activities) given a patient scenario of hearing loss type (e.g., SNHL).
    • 9) Identify which patient scenario would most likely require a medical referral based on given symptoms (e.g., impacted cerumen, asymmetric hearing loss, sudden onset hearing loss).
    • 10) Identify the most appropriate type of preventative hearing protection given a patient scenario involving noise exposure.
    • 11) Differentiate between scenarios that indicate a hearing loss vs. lack of understanding (e.g., cognitive decline, retrocochlear).
  • DOMAIN 2: Test and analyze patient hearing (25%) (25%)
    • 1) Identify irregularities/obstructions during an otoscopic examination.
    • 2) Identify when the patient would benefit from cerumen management, removal, and/or precautions in cerumen management.
    • 3) Identify the degree and type of hearing loss based on the pure-tone air and bone-conduction given audiometric results (e.g., mixed hearing loss, SNHL).
    • 4) Identify condition(s) that would cause the tympanogram and/or reflex configuration given tympanogram and/or reflex results.
    • 5) Identify potential methods for managing tinnitus.
    • 6) Identify when to conduct speech awareness vs. speech reception threshold test.
    • 7) Identify how speech discrimination test results would impact the patient's outcome, most appropriate treatment option, or additional testing.
    • 8) Determine whether this was over masked, under masked, effectively masked, masking was not necessary, or a masking anomaly (e.g., interaural attenuation) given audiometric test results showing air- and/or bone-conduction testing and masking levels.
    • 9) Identify the potential impact on fitting given a patient scenario involving Speech Reception Threshold (SRT), Most Comfortable Listening Level (MCL), and/or Uncomfortable Loudness Level (UCL) (e.g., recruitment).
    • 10) Interpret Speech in Noise (SIN) results and impact on treatment plan.
    • 11) Identify signs of irregular test results and/or the potential causes of irregular test results (e.g., malingering, user error, equipment failure).
    • 12) Identify the results that indicate recommendation for medical referral given otological or hearing test results (e.g., binaural interference, PTA vs. SRT discrepancy, air-bone gap).
    • 13) Identify when a client is a possible candidate for a surgical solution (e.g., cochlear implant, Bone-anchored Hearing Aid (BAHA), PE tubes).
    • 14) Select the best audiometric transducer given physical considerations of the patient (e.g., supra-aural vs. insert earphones).
  • DOMAIN 3: Prescribe and analyze hearing instruments (25%) (25%)
    • 1) Identify the appropriate hearing instrument (e.g., style, configuration, matrix, rechargeable vs. battery) given a patient scenario that includes physical and/or cognitive limitations.
    • 2) Identify which telephone use options are most appropriate given a patient scenario including physical/cognitive limitations or knowledge of technology.
    • 3) Identify which Assistive Listening Devices (ALDs) are most appropriate given a patient scenario that includes lifestyle, physical/cognitive limitations and/or knowledge of technology.
    • 4) Identify the contraindications for Invisible-in-Canal (IIC) hearing instruments given a patient's ear canal, size, hearing loss and lifestyle (i.e., extended or daily wear use).
    • 5) Identify the most appropriate modification to the procedures and/or materials during an ear impression (e.g., gun vs. syringe, otoblock size/type, mastoid and/or piercings, unusual/missing pinna).
    • 6) Identify the most appropriate tube, tube length, dome size, earmold, or receiver power for over-the-ear (OTE) hearing instruments.
    • 7) Identify the most appropriate wire, wire length, dome size, earmold, or receiver power for receiver-in-canal (RIC) hearing instruments.
    • 8) Identify the most appropriate tube, tube length, dome size, earmold, or receiver power for behind-the-ear (BTE) hearing instruments.
    • 9) Identify advantages and disadvantages of custom hearing instruments versus OTE, RIC, and BTE given a patient scenario.
    • 10) Identify advantages and disadvantages of custom hearing instruments given a patient scenario.
    • 11) Identify possible treatment options for asymmetrical and single-sided deafness (SSD) (e.g., CROS/BICROS).
    • 12) Determine the most appropriate hearing instrument given a patient scenario that includes lifestyle, history, test results, and ear canal characteristics.
  • DOMAIN 4: Fit, adjust, program, and service hearing instruments and equipment (15%) (15%)
    • 1) Identify the appropriate adjustment given objective verification outcome results (e.g., sound field aided/unaided discrimination, sound field aided/unaided warble tones or narrow band noise).
    • 2) Identify potential causes of problems or identify the appropriate modification given results from real ear or speech mapping.
    • 3) Identify the appropriate methodologies for modifying the physical fit of earmolds, custom shells, OTE, BTE, and/or RIC instruments given a patient complaint.
    • 4) Identify the appropriate adjustments given subjective validation of results (e.g., COSI, IOI-HA, APHAB, verbal feedback).
    • 5) Troubleshoot and adjust/modify programming of hearing instrument given a patient complaint.
    • 6) Identify or resolve potential hearing instrument problems caused by obstructions, moisture, or battery performance.
    • 7) Troubleshoot pairing and wireless connectivity between hearing-related devices.
  • DOMAIN 5: Counseling and rehabilitation (10%) (10%)
    • 1) Identify the most appropriate patient explanation given results of otoscopic examination and audiometric examination.
    • 2) Identify potential limitations and benefits of amplification.
    • 3) Identify the most appropriate counseling based on subjective validation results.
    • 4) Identify helpful strategies and information for improved hearing and communication in various situations or environments.
    • 5) Identify appropriate manual hearing instrument adjustments that patients, family members, or caregivers can make.
Examination sources