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BOPC : forms

Board of Professional Counselors

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IMPORTANT NOTICE:
 
 " Effective January 1, 2014 all new applicants for licensure, certification,and trainee status must have a    criminal history records check."
  
Criminal History Records Check Information          
  Pre-registration form. (This form will be mailed to you).       
  
Alcohol & Drug Trainee Applications
 
Alcohol Drug Trainee Application AD#1          
  Pre-Application Credentials Evaluation for Trainee       AD#2        
  Alcohol Drug Trainee Supervisor Information               AD#3         

Alcohol & Drug Applications

  Alcohol and Drug CSC-AD Application                       AD#4        
  Alcohol and Drug CACAD Application                        AD#5        
  LCADC Application                                                  AD#6        
  Alcohol Drug LGADC Application                              AD#7        
  Transfer from LGADC to LCADC                               AD#8        
  Pre Application Credentials Evaluation for CSC-AD    AD#9        
  Pre Application Credentials Evaluation for CAC-AD    AD#10        
  Pre-Application Credentials Evaluation for LCADC and LGADC   AD#11        
  ALCOHOL AND DRUG Out Of State Application                           AD#12 (click here) 

Professional Counselor Applications

  Pre-Application Credentials Evaluation for LCPC                    PC#1        
  LCPC Application                                                               PC#2        
  LGPC Application                                                               PC#3        
  Transfer from LGPC to LCPC                                               PC#4        
  Supervised Clinical Documentation Form                              PC#5       
  Educational  requirement information for LCPC and LGPPC   PC#6        
  LGPC Supervision Requirements Regulation                         PC#7        
  LCPC Out Of State Application                                                 PC#8 (click here) 

Marriage And Family Therapy    

  Pre-Application Credentials Evaluation for LCMFT        
  LCMFT Application        
  LGMFT Application        
  Transfer from LGMFT to LCMFT        
  LCMFT Out Of State Application (click here) 

Art Therapy Applications    

Licensure By Waiver Application        
Licensure Application        
Licensed Graduate Professional Art Therapists (LGPAT)        

Miscellaneous Forms    

  Name Change        
  Duplicate License Request        
  Application for Inactive Licensure / Certification Status        
  Address Change (click here)
  Verification Request Form