The DHEC 221 form serves as the official application for individuals seeking licensure as hearing aid specialists in South Carolina. This form must be completed and submitted under oath, ensuring that both new applicants and those renewing their licenses comply with state regulations. The application requires personal information, including the applicant's name, contact details, and business addresses, to facilitate communication and record-keeping. Additionally, applicants must provide details about their primary business location, including operating hours and contact numbers. If applicable, secondary locations can also be listed. The form includes sections that inquire about the applicant's background, such as previous licenses held in other states and any criminal convictions. Furthermore, to demonstrate ongoing professional development, applicants must submit proof of continuing education and current calibration documentation for any audiometers in use. A licensing fee is also required with the submission. This comprehensive application process is designed to ensure that all hearing aid specialists meet the necessary qualifications and adhere to the standards set forth by the South Carolina Department of Health and Environmental Control.