Home | Licensee Lookup | Inside LLR | Media/FOIA Center

Forms, Instructions and License Applications

Some of the following files are in portable document format (PDF) and require the Adobe Acrobat Reader to view and print these files to a printer. Download a FREE copy of Acrobat Reader.

---

Applications :

• Check Your Application Status Online

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

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

• Licensure List Request - $10 (download form)

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

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

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

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

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

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

Psycho-Educational Specialist (LPES) Application Packet

• Application & Requirements

• Endorsement from Another State Instructions

• List of Supervisors - LPES Licensees

• LPES Supervisor's Report Form

Transferring a License by Endorsement from Another State

• Instructions

• Verification of Licensure for Endorsement

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

Back to Top