Application to Resume Active PracticeShelly2020-08-17T14:44:37-06:00
Please complete the form below if you are a non-practicing ACSLPA member who wants to return to active practice status.
Before you proceed, ensure the following information is correct in your ACSLPA online profile or there may be a delay in processing your status change. Click hereto review or change your profile before completing the ‘Application to Resume Active Practice’ form if you are unsure.
Contact information, including your name, address, phone, etc.
Insurance Information (Click here to view the mandatory ACSLPA PLI requirements)
A payment of $40/month from the date of returning to active practice until the end of the year is required. At the end of this form payment will be required via Visa,
Visa Debit or MasterCard.
Once your request has been processed you will be notified and will need to login to the online system again to update your employer information.