Please complete the form below if you will no longer practice in your profession in Alberta.

  • You do not plan to work or volunteer in Alberta in the future and do not wish to be a member of ACSLPA.

Before you proceed, ensure information is correct in your ACSLPA online profile or there may be a delay in processing your status change. Click here to review or change your profile before completing the ‘Application to Resume Active Practice’ form if you are unsure.

Resignation from ACSLPA

  • Registration Number
  • Date Format: MM slash DD slash YYYY
    Date Status Change is required
  • Declarations

  • HPA – Schedule 28 - Practice of Speech-Language Pathology and Practice of Audiology
  • Practice
    3(1) In their practice, speech-language pathologists do one or more of the following:

    (a) assess, diagnose, rehabilitate and prevent communication and oral motor and pharyngeal dysfunctions and disorders,

    (b) teach, manage and conduct research in the science and practice of speech-language pathology, and

    (c) provide restricted activities authorized by the regulations.

    3(2) In their practice, audiologists do one or more of the following:

    (a) assess auditory and vestibular function and diagnose, rehabilitate, prevent and provide appropriate devices and treatment for auditory and vestibular dysfunction,

    (b) teach, manage and conduct research in the science and practice of audiology, and

    (c) provide restricted activities authorized by the regulations.

  • ACSLPA staff will contact you within 2 - 4 business days to confirm your submission.