Virginia Board of Counseling
Applications and Instructions
The links below 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
Reinstatement Application for Certified Substance Abuse Counselors
Certified Substance Abuse Counselor Assistants
Application packet
for Certified Substance Abuse Counselor Assistant - 8-21-2009
Reinstatement Application for Certified Substance Abuse Counselor Assistant
Licensed Professional Counselors
Application package for Licensed Professional Counselors - 11-26-2012
Verification of Clinical Duties
Reinstatement Application for Licensed Professional Counselors
Application for Reinstatement of a Revoked, Suspended or Surrendered License
Licensed Substance Abuse Treatment Practitioners
Application Packet for Licensed Substance Abuse Treatment Practitioners - 1-24-2011
Reinstatement Application for Licensed Substance Abuse Treatement Practitioners - 7-14-2011
Certified Rehabilitation Providers
General Information for Certification as a Rehabilitation Provider
Application for Certification as a Rehabilitation Provider
Verification of Experience for Rehabilitation Provider Certification
Verification of Licensure/Certification
Licensure/Certification Verification of Out-of-State Supervisor
Rehabilitation Provider Application for Reinstatement of a Lapsed Certificate
Marriage and Family Therapists
Application Packet for Marriage and Family Therapist - 12-19-2012
Reinstatement Application for Marriage and Family Therapists
Continuing Education Forms
Continuing Education Summary Form - LPC
Continuing Education Summary Form - LMFT
Continuing Education Summary Form - LSATP
Formal Staffing Attendance Form
Form for Reporting Counseling Independent Study
Compliance Forms & Information
Self Report Form
Licensed Professional Counselor
Performance Evaluation Form
Supervisor Report Form – Behavioral Sciences
Miscellaneous Forms
Drug Log for Prescribers (.xls)
Employer Notified of Board Order
Prescriber Report to Board of Drugs or Prescription Given to Licensee
Recovery Support Group Attendance Log
Approval Forms
Chaperone Approval Request Form
Supervisor Approval Request – Behavioral Sciences