Name Modify Documentation (if relevant): Documentation of any lawful title change Should your identify differs from that on any of your respective files.

Name Transform Documentation: Documentation of any lawful identify alter If the identify differs from that on any of the documents.

Documentation may well contain a copy within your marriage certification or divorce decree.  Make sure you upload at time of software or log again into your account and use the License Update possibility.

Once you call us or submit the form on this page, you’ll be assigned a licensed Scientific Assessment Therapist who will plan a private, totally free assessment.

Other jurisdictions may possibly cost a rate to verify licensure. You could possibly would like to contact the state boards ahead of your ask for for verification. You don't need to have to accomplish this form if You simply hold licensure or certification inside the Point out of Indiana.

The folks we serve are supported by a workforce of therapists and clinicians who finish an assessment and put into action ongoing immediate supervision as a way to make sure development and an increase in constructive conduct.

Make sure you Be aware: All applicants need to have finished supervised clinical experience in the next precise groups of situations:

The highest part of this manner need to be completed by the applicant and despatched to the appropriate condition licensing board for their submission towards the Indiana Specialist Licensing Agency. The shape may be duplicated if you keep many licenses.

Assessment Acceptance: At the time all documentation has actually been reviewed and accepted, an applicant that has not taken the countrywide Test will acquire an Examination acceptance from our Place of work. An applicant who has become accepted because of the Board to take the assessment must take the assessment within just one (1) calendar 12 months within the day on the Original Board acceptance. Should the applicant has not taken the examination in just 1 (1) calendar yr from the date of Preliminary Board acceptance, the approval is going to be invalid and also the applicant should submit a new application and all needed documentation need to be resubmitted.

Yet another condition-controlled addiction counseling Qualified or, In the event the encounter was attained website inside a point out where no regulation exists, by an addictions or behavioral health Experienced of equal position;

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All schooling requirements need to be fulfilled by postsecondary instructional programs. Certifications can't be used to fulfill instructional prerequisites.

You may still submit an application for licensure, but eligibility for licensure will depend upon the person facts and conditions of the criminal history.

You can be necessary to make up the continuing education hours you happen to be quick and you'll need to spend a high-quality.  The Board has adopted the proposed program like a normal guideline for continuing education and learning violations: