Pdf Forms below require the Free Adobe Acrobat Reader to View or Print.

• Application Form (pdf) Updated 11/18/2009
• Application Instructions (pdf) Updated 07/08/2009
• Request for transcript & certification letter (pdf) Updated 07/08/2009
• Verification of licensure in another state (pdf)
• Application Checklist (pdf)
• Name and or Address Change Form (pdf)

Criminal Background Check Forms:
Criminal Background Check Forms are mailed to applicants upon receipt of application for licensure.

Forms for Filing a Complaint:

• Complaint form (pdf) Updated 07/08/2009
• Witness form (pdf) Updated 07/08/2009

Forms for License Renewal:

• Renewal Application Packet (pdf) Updated 07/08/2009
• Form for reporting Continuing Education (pdf) Updated 07/08/2009

Supervision Forms:

• Supervision Plan form (pdf) Updated 07/24/2009
• LCSW Supervision Evaluation form (pdf) Updated 09/11/2009
• LCSW Supervision Guidelines (pdf) Updated 07/24/2009