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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

Substance Abuse Counselor or Counseling Assistant Application for Reinstatement of Certificate Following Revocation or Suspension

 

Certified Substance Abuse Counselor Assistants

Application packet for Certified Substance Abuse Counselor Assistant

Reinstatement Application for Certified Substance Abuse Counselor Assistant

Substance Abuse Counselor or Counseling Assistant Application for Reinstatement of Certificate Following Revocation or Suspension

 

Licensed Professional Counselors

LPC Licensure Process Handbook

Application Packet for Initial Supervised Residency

Application Packet to Add/Change to Supervision

Application Packet for LPC by Examination

Application Packet for LPC by Endorsement

Reinstatement Application Packet for Licensed Professional Counselors

Application Packet for Reinstatement of a Revoked, Suspended or Surrendered License


Additional LPC Forms

BOC Verification of Education and Internship Form

Licensure Verification of Out of State Supervisor

Verification of Clinical Supervision

Quarterly Evaluations

Request for Termination of Supervision

Verification of LPC License from Another State (LPC Endorsement Applicants)

Verification of Clinical Practice for 24 of the Last 60 Months

Verification of Education and Internship

Request for Name and/or Address Change

Request for Verification of Virginia LPC License

 

Licensed Substance Abuse Treatment Practitioners

Registration/Application Packet for Licensed Substance Abuse Treatment Practitioners - 07/03/2014

Reinstatement Application for Licensed Substance Abuse Treatement Practitioners - 07/03/2014

 

Certified Rehabilitation Providers

General Information for Certification as a Rehabilitation Provider

Memo regarding Applications

Frequently Asked Questions

Application for Certification as a Rehabilitation Provider - 07/03/2014

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 - 07/03/2014

 

Marriage and Family Therapists

Application Packet for Marriage and Family Therapist - 07/03/2014

Reinstatement Application for Marriage and Family Therapist - 07/03/2014

 

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

Compliance FAQs

Self Report Form

Licensed Professional Counselor

Performance Evaluation Form

Supervisor Report Form – Behavioral Sciences

Chaperone Report Form

Miscellaneous Forms

Chaperone Fact Sheet

Drug Log for Prescribers (.xls)

Employer Notified of Board Order

Initial Contact Form

Prescriber Report to Board of Drugs or Prescription Given to Licensee

Recovery Support Group Attendance Log

Approval Forms

Chaperone Approval Request Form

Evaluator Approval Request

Supervisor Approval Request – Behavioral Sciences

Therapist Approval Request