PLEASE DO NOT FAX OR EMAIL YOUR APPLICATION.

Background checks are taking approximately 4 weeks to be returned to the Board Office.  

Application review time is approximately an additional 2-3 weeks after the Board receives all materials to complete your application.

New Certification

If you have never held the certification you are applying for in any state or do not hold an active certification in any state, use these forms.   Download and print all of the following documents as part of the application packet:

• Instructions

• Application

• Supervision Agreement

• Proof of Lawful Presence

• Disclosure Statement Requirements

• Fingerprint Instructions for applications - You must complete and submit TWO (2) FD-258 fingerprint cards.

If you are applying for the Certified Mental Health Worker, you will also need:

• Transcript Evaluation Form - CMHW

If you are applying for the Certified Addictions Practitioner Assistant, you will also need:

• Training Evaluation Form - CAPA

If you are applying for the Certified Addictions Practitioner and have a baccalaureate degree in a human resource discipline, you will also need:

• Transcript Evaluation Form - CAP

Certification by Reciprocity

If you hold a current and active certification in another state, use these forms.  Download and print all of the following documents as part of the application packet:

• Instructions

• Application

• Supervision Agreement

• Proof of Lawful Presence

• License Verification Request to Another State

• Disclosure Statement Requirements

• Fingerprint instructions for applications