Forms
Background Check Forms
- Criminal Record Check Instructions for licensure applicants
- Criminal Record Check Instructions for RENEWAL
- RAP Disclosure Form
- Authorization Form
- Automated Process Form (In-person to LSP only)
- Privacy Statement & Acknowledgement Signature Form
- Notice to Applicants
Sample Statement and Declaration of Practices and Procedures
- PLMFT Statement of Practices and Procedures
- LMFT Statement of Practices and Procedures
- PLPC Declaration of Practices and Procedures
- LPC Declaration of Practices and Procedures
- LPC-S Declaration of Practices and Procedures
- Teletherapy Addendum
Licensee Forms
- Complaint Form
- PLMFT Documentation of Experience Form
- PLPC Documentation of Experience Form
- Expedited Processing Form
- LMFT Documentation of Supervision of Supervision Form
- Endorsement Applicant License Verification Form