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Virginia Board of Counseling
Applications and Instructions

 

Please contact the Board at (804) 367-4610 or coun@dhp.virginia.gov for information on the following forms:

Licensed Substance Abuse Treatment Practitioners Applications

Certified Substance Abuse Counseling Assistants Applications

 

The below documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer 97/2000 to view and print DHP's documents.

Certified Substance Abuse Counselors

Application packet for Certified Substance Abuse Counselors

Licensed Professional Counselor Application

Application package for Licensed Professional Counselors

Certified Rehabilitation Provider Application

General Application Information

Memo regarding Applications

Frequently Asked Questions

Application Form (Form 1) 

Verification of Experience (Form 2)

Verification of Licensure/Certification (Form 3)

Verification of Out-of-State Supervisor (Form 4)

Application for Reinstatement of a Lapsed Certificate

Marriage and Family Therapist Applications

Memo regarding Applications

 Application Information

Application (Form 1)

License Verification of Applicant (Form 2)

Verification of Supervision (Form 3)

Quarterly Evaluation (Form 3B)

License Verification for Out-of-State Supervisor (Form 4)

Courses Outline (Form 5)

Verification of Internship (Form 6)

Verification of Internship Hours toward the Residency (Form 7)

Supervision Outline Form for Endorsement Applicants (Form 8)

Registration of Supervision Forms

Registration of Supervision Instructions

Registration of Supervision Form (Form A)

License Verification for Out-of-State Supervisor (Form B)

Quarterly Evaluation Form (3B)

Continuing Education Forms

Continuing Education Summary Form - LPC

Continuing Education Summary Form - LMFT

Continuing Education Summary Form - LSATP

Formal Staffing Attendance Form