Applications and Forms

Important Notice Regarding Licensure Applications

As of January 1, 2010 all licensure applications must include two professional references on forms furnished by the Board for such purpose. All applications will be updated to include the required form and instructions in the coming months.

Mental Health Counseling Licensure Application 

Mental Health Counseling Exam Registration Form 

Marriage and Family Therapists Licensure Application 

Educational Psychologists Licensure Application 

Rehabilitation Counselors Licensure Application 

Online Address Change for Allied Mental Health and Human Services Professionals

The Online Change of Address feature allows you to change your address of record listed in our database. To use this function, you must provide certain information for authorization.

Change of Name or Request for Duplicate License for Board of Registration of Allied Mental Health and Human Services Professionals

This PDF form maybe used to request a name change, address change or a duplicate license.

Health Care Fraud Complaint Application 

Note: The Health Care Fraud Application is for use by insurance companies and fraud agencies.

Division of Professional Licensure Complaint Form