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

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF COUNSELING
Chapter 80
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: 18VAC115-80. Regulations Governing the Registration of Qualified Mental Health Professionals.

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 (18VAC115-80)

The following forms are available online only at https://www.license.dhp.virginia.gov/apply/:

Qualified Mental Health Profession-Adult, Application and Instructions

Qualified Mental Health Profession-Child, Application and Instructions

Supervised Trainee, Application and Instructions

Verification of Supervised Experience for a Qualified Mental Health Profession-Adult (eff. 10/2018)

Verification of supervised experience for a Qualified Mental Health Profession-Child (eff. 10/2018)

Verification of Internship/Practicum for a Qualified Mental Health Profession (eff. 7/2018)

Verification of Supervised Experience for a Qualified Mental Health Professional-Adult (QMHP-A) (rev. 11/2019)

Verification of supervised experience for a Qualified Mental Health Professional-Child (QMHP-C) (rev. 11/2019)

Verification of Internship/Practicum for a Qualified Mental Health Professional (QMHP) (rev. 11/2019)

Reinstatement Instructions for a Qualified Mental Health Professional-Adult (QMHP-A) (rev. 7/2020)

Reinstatement Instructions for a Qualified Mental Health Professional-Child (QMHP-C) (rev. 7/2020)

VA.R. Doc. No. R21-6624; Filed January 05, 2021