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Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists and Psycho-Educational Specialists

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Forms, Instructions and License Applications

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Applications :

• Check Your Application Status Online

• Application & Credentialing Information for Professional Counselors (LPC) and Marriage and Family Therapists (LMFT)

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Forms :

• Disclosure Statement Article (pdf)

• Examples of Disclosure Statement Forms (pdf)

• Complaint Form (pdf)

• Change of Name Instructions/Form  (pdf) - Legal document required

• Change of Address Form Online

• License Verification Request Online

• Licensee List Request - $10

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Marriage and Family Therapist (LMFT) and Intern

• Application Packet - LMFT and Intern

• Coursework Requirements

• Confirmation of Clinical Supervision for LMFT

• Intern Supervision Log

• List of Supervisors

• Plan for Clinical Supervision of Post-Master's Client Contact in Marriage and Family Therapy

• Supervision Guidelines for Licensure of Professional Counselors and Marriage & Family Therapists

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Marriage and Family Therapist (LMFT) Supervisor

• Application & Requirements

• Candidate Log Control Sheet

• Candidate Supervision Guidelines

• Change in Supervisor License - Effective July 1, 2004

• List of Supervisors

• LMFT Supervisor Candidate Procedures

• Plan of Supervision

• Supervisor Log Sheet

• Board Approved Supervisor Courses

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Professional Counselor (LPC) and Intern Application Packet

• Application Packet - LPC and Intern

• Coursework Requirements

• Confirmation of Clinical Supervision of Post-Master's Client Contact in Counseling

• Intern Supervision Log

• List of Supervisors

• NBCC Study Guide Order Form

• Policy Statement for Supervision of Licensed Professional Counselors Interns

• Supervision Guidelines for Licensure of Professional Counselors and Marriage & Family Therapists

• Plan for Clinical Supervision

• Exam Announcement

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Professional Counselor (LPC) Supervisor

• Application & Requirements

• Candidate Log Control Sheet

• Candidate Supervision Guidelines

• Change in Supervisor License - Effective July 1, 2004

• LPC Supervisor Candidate Procedures

• List of Supervisors

• Plan of Supervision

• Supervisor Log Sheet

• Board Approved Supervisor Courses

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Extensions for LPC & LMFT Interns

• Extension Form for Interns

• Extension Request Instructions

• Plan for Clinical Supervision of Post-Master's Client Contact in Counseling

• Plan for Clinical Supervision of Post-Master's Client Contact in Marriage and Family Therapy

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Transfer Intern License to Full Licensure Status

• Transfer of Intern License Instructions

• Transfer Request Form

• Confirmation of Clinical Supervision - LPC

• Confirmation of Clinical Supervision - LMFT (licenses issued after 5/26/2006)

• Intern Supervision Log

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Psycho-Educational Specialist (LPES) Application Packet

• Application & Requirements

• Endorsement from Another State Instructions

• List of Supervisors - LPES Licensees

• LPES Supervisor's Report Form

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Transferring a License by Endorsement from Another State

• Instructions

• Verification of Licensure for Endorsement

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Late Renewal, Reinstatement and Re-Application Information

• Instructions

• Reinstatement Application-For All Licenses

• Re-application-LPC and LPC Intern

• Re-application-LMFT and LMFT Intern

• Re-Application - LPES

• Supervisor Re-Application- LPC/S and LMFT/S

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