Important Notice Regarding Licensure ApplicationsAs 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.
- 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 ProfessionalsThis PDF form maybe used to request a name change, address change or a duplicate license.
- Note: The Health Care Fraud Application is for use by insurance companies and fraud agencies.