REGULATIONS
Vol. 37 Iss. 12 - February 01, 2021

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF COUNSELING
Chapter 30
Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Title of Regulation: 18VAC115-30. Regulations Governing the Certification of Substance Abuse Counselors and Substance Abuse Counseling Assistants.

Effective Date: February 1, 2021.

Agency Contact: Elaine Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Henrico, VA 23233, telephone (804) 367-4688, FAX (804) 527-4434, or email elaine.yeatts@dhp.virginia.gov.

FORMS (18VAC115-30)

Certification Application – Certified Substance Abuse Counselor (rev. 1/08).

Registration of Supervision – Form 1 (rev. 1/08).

Verification of Supervision, Form CSAC-2VS (rev. 1/08).

Licensure Verification of Out-of-State Supervisor, Form CSAC-LV (rev. 1/08).

Substance Abuse Education Outline, Form CSAC-EO (rev. 1/08).

Substance Abuse Education Tasks, Form CSAC-ET (rev. 1/08).

CSAC-A Certification Application (rev. 8/09).

Substance Abuse Education Outline, Form CSAC-A-EO (rev. 8/09).

Substance Abuse Education Tasks, Form CSAC-A-ET (rev. 8/09).

Verification of Licensure/Certification, Form CSAC-VL (rev. 1/08).

Application for Reinstatement of a Lapsed Certification (rev. 8/07).

Application Instructions Certified Substance Abuse Counselor (CSAC) By Examination (rev. 1/2020).

Application Instructions Certified Substance Abuse Counselor (CSAC) By Endorsement (rev. 1/2020).

Paper Application Instructions for Initial Registration of Supervision for Certified Substance Abuse Counselor (CSAC) (rev. 1/2020).

Paper Application Instructions for Add/Change Registration of Supervision for Certified Substance Abuse Counselor (CSAC) (rev. 1/2020).

Certified Substance Abuse Counselor (CSAC) Verification of Supervision Form (rev. 1/2020).

CSAC Didactic Training Required for Registration of Supervision (rev. 1/2020).

Request for Termination of Supervision (rev. 4/2018).

Supervisor Out-of-State Licensure Verification (rev. 4/2018).

Application Instructions: Certified Substance Abuse Counselor Assistant (CSAC-A) By Examination (rev. 1/2020).

CSAC-A Verification of Experience While Under Supervision (rev. 4/2018).

CSAC-A Didactic Training Verification (rev. 4/2018).

Request for Verification of Virginia Counseling License/Certification/Registration (rev. 5/2018).

Applicant Out-of-State Licensure/Certification Verification (rev. 4/2018).

Application Instructions: CSAC and CSAC-A Reinstatement (rev. 1/2020).

Application for Reinstatement of a CSAC and CSAC-A Following Revocation or Suspension (rev. 4/2018).

VA.R. Doc. No. R21-6626; Filed January 05, 2021