FHS Member Application

Please use this form to become a Florida Hearing Society Member. After creating your account, you will subscribe to a membership type.

Membership Options:
Select Yearly or Monthly Membership if your are an individual that needs CEUs for your licensing.
Select Associate Member if you are an individual that does not need CEUs and you are an owner or support staff for another member.

If you have a current paid membership, and using Forgot Password does not work, contact us by email so we can verify and update your account.

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* First

* Last

* Mobile Phone This is for us to reach you, it is not public.

* Company This business information is used in the public directory

* Business Address

* Business City

* Business State

* Business Zip

* County Location of Office This is the County of which your office is located. Your primary location of your business address.

* Business Phone

* Business Email

* Mailing Address The mailing address is not shared with the public.

* Mailing City

* Mailing State

* Mailing Zip

* License Number, if Applicable

Anniversary Date of License, if applicable This is the date you first received your license.

Please select licenses and/or credentials, if applicable

Audioprosthology (ACA)
Board Certified Hearing Instrument Specialist (BC-HIS)
Certificate of Clinical Competency in Audiology (CCC-A)
Certified Dementia Practitioner (CDP)
Doctor of Audiology (Au.D.)
Doctoral Degree (Ph.D.)
Hearing Aid Specialist (HAS)
Tinnitus Certified

If you are not licensed, what is your association with the hearing industry?

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Florida Hearing Society ID:

Password:

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