Dyslexia Therapy Forms

License Application

DYS001 Dyslexia Therapy License Application (PDF) revised October 2018

Disciplinary Action Questionnaire (PDF)


Change of Information or Duplicate License

DYS002 Dyslexia Therapy Notice of Change and Duplicate License Request (PDF)


Criminal History Forms

Criminal History Questionnaire (PDF)

Criminal History Evaluation Letter


Other Forms

TDLR Complaint Sign (PDF)

Military Service Member, Military Veteran, or Military Spouse Supplemental Application (PDF) - see Military Spouse Frequently Asked Questions

Request to Executive Director for Expired License Renewal (PDF)


File Viewing Information

These forms are available for download in Adobe Acrobat .pdf format. Acrobat Reader is necessary to view .pdf files. If you need to obtain a copy of this program it is available as a free download for Windows or Macintosh operating systems.

Please note the following policy regarding the filing of forms which collect a person's individual information:

An individual who completes and files this form with the Texas Department of Licensing and Regulation (the Department) is entitled to the following from the Department:

  • (1) to be informed about the information that the Department collects about the individual, upon the request of the individual and subject to a few exceptions;
  • (2) to receive and review the information, under Sections 552.021 and 552.023 of the Texas Government Code; and
  • (3) to have the Department correct information about the individual that is incorrect, under Section 559.004 of the Texas Government Code.