Virginia Board of Social Work
Applicatons & Forms
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.
Regulations Governing the Practice of Social Work
Licensed Clinical Social Worker Application Forms
Clinical Social Worker Licensure Application
Verification of Clinical Supervision
Licensure Verification of Out-of-State Supervisor
Out-of-State Licensure Verification
General Information for Licensure by Examination as a Licensed Clinical Social Worker
General Information for Licensure by Endorsement as a Licensed Clinical Social Worker
Licensed Social Worker Application Forms
Social Worker Licensure Application
Verification of Casework Management and Supportive Services
Licensure Verification of Out-of-State Supervisor
Out-of-State Licensure Verification
General Information for Licensure by Examination as a Licensed Social Worker
General Information for Licensure by Endorsement as a Licensed Social Worker
Reinstatement
Reinstatement after Disciplinary Action
Reinstatement - Licensed Clinical Social Worker
Reinstatement - Licensed Social Worker
Registration of Supervision
Instructions for Registration of Supervision for LCSW
Registration of Supervision Post-Graduate Degree Supervised Experience
Instructions for Registration of Supervision for LSW
Registration of Supervision for LSW
Continuing Education Forms
Continuing Education Summary Form
Form for Reporting Social Work Attendance At Formal Staffing
Form for Reporting Social Work Independent Study
Compliance Forms & Information
Self Report Form
Licensed Clinical Social Worker
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