Self-Reporting of Disciplinary Actions and Criminal Convictions to the ASHA Ethics Office

Online Self-Report Form

What is Self-Reporting?

Self-reporting is the proactive and deliberate disclosure of professional discipline/licensure actions or specific criminal convictions to the ASHA Ethics Office in accordance with the ASHA Code of Ethics (Principle IV, Rules T and U) and the Assistants Code of Conduct (Principle III, Conduct Fundamentals O and P).

Who Should Self-Report?

Individuals required to self-report are

  • ASHA members,
  • ASHA Certificate of Clinical Competence (CCC) holders,
  • certified assistants who hold the ASHA C-AA or C-SLPA, and
  • applicants for certification.

When Should You Self-Report?

Individuals have 60 days from the date of a final action, conviction, or disposition to self-report to the ASHA Ethics Office. Waiting until you renew your certification might result in an ethics violation if it falls outside the 60-day period. Civil litigation and malpractice actions don’t need to be reported to the ASHA Ethics Office.

Ultimately, it’s always better to report a conviction or licensing action. Court records and licensing decisions are typically public information, which makes it likely that at some point ASHA will learn about the criminal or licensing action taken against you.

How to Self-Report

By mail or email

Complete a Self-Report Form [PDF], making sure you have entered all required information and that you’ve included copies of your court or board disposition records.

Mail your Self-Report Form and your state disciplinary decision/court records in an envelope marked "Confidential" to:

ASHA Ethics Office
2200 Research Blvd., #309
Rockville, MD 20850

Email your Self-Report Form and your state disciplinary decision/court records attached to an email marked "Confidential" to 


Complete an online Self-Report Form and attach the proper documentation. If the file or files are too large to attach, please email the document(s) as a PDF attachment(s) to

Required Documentation

For criminal convictions, the ASHA Ethics Office requires a copy of the conviction, plea, or nolo contendere record with the self-report notification. For licensing and regulatory decisions, you should provide a copy of the final action, consent order, sanction, and/or disposition from the state board or regulatory body.

What Happens Next?

The ASHA Ethics Office will review your submitted form and documents to determine if your self-report includes the required information and documentation described above. If your self-report meets these requirements, the ASHA Ethics Office will confirm receipt of the self-report and provide you with an opportunity to submit any additional information you deem relevant within 45 days. You are not required to submit any additional information during this time. If your self-report does not contain all the required information or documentation, the Ethics Office will contact you and request further information.

If the Board of Ethics (BOE) Chair determines that your self-report constitutes a de minimis violation of the Code of Ethics, they can dismiss your self-report. In that event, your case will be considered closed and will not be sent to the BOE for Initial Consideration. You will receive a letter from the BOE Chair confirming this determination.

If the BOE Chair determines that your self-report should be reviewed by the BOE, your case will be sent to the BOE for Initial Consideration. However, your act of self-reporting shows the BOE that you are taking responsibility for your actions and acting ethically, which will be considered by the BOE during its adjudication process. When the BOE makes an initial determination in your case, you will be notified by the ASHA Ethics Office.

Questions on Self-Reporting?

For more information on self-reporting, you can

ASHA Corporate Partners