Wyoming Mental Health Professions Licensing Board
You must download or print the form from the File menu once you have opened the document. Editing access will not be granted.
Supervision Agreement - To request approval to practice under a supervisor.
VESE Form - To have a supervisor report completed supervision hours.
Addendum to VESE - To report additional hours from a previous submission.
Address and Name Change Form - To change your name and/or address with the Board.
Replacement Wall Certificate or Pocket Card Form - To request a replacement wall certificate or pocket card.
Verification Form (Wyoming License to another state) - To request your Wyoming license be verified to another jurisdiction or entity.
Verification of Other State License - To have another licensing jurisdiction verify your information to Wyoming.
Supporting Documents for Applications
Transcript Evaluation - LMFT (enrollment prior to 1/1/2020)
Transcript Evaluation - LMFT (enrollment after to 1/1/2020)