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 Forms

Supervision Agreement

VESE Form

Addendum to VESE - Only used to report additional hours from a previous submission.

Miscellaneous Form

Address and Name Change Form

Replacement Wall Certificate or Pocket Card Form

Verification Form (Wyoming License to another state)

Verification of Other State License


Supporting Documents for Applications

Disclosure Statement Requirements

Proof of Lawful Presence

Training Evaluation - CAPA

Transcript Evaluation - CAP

Transcript Evaluation - CMHW

Transcript Evaluation - LAT

Transcript Evaluation - LPC

Transcript Evaluation - LMFT (enrollment prior to 1/1/2020)

Transcript Evaluation - LMFT (enrollment after to 1/1/2020)

The Wyoming Mental Health Professions Licensing Board is staffed through the Professional Licensing Boards Office, a division of A&I.