TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
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: 18VAC115-20. Regulations Governing the Practice of Professional Counseling.
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 (18VAC115-20)
Registration of Supervision - Post Graduate Degree Supervised Experience, LPC Form 1 (rev. 2/2011).
Quarterly Evaluation, LPC Form 1-QE (rev. 2/2011).
Licensure Verification of Out-of-State Supervisor, LPC Form 1-LV (rev. 2/2011).
Licensure Application, LPC Form 2 (rev. 2/2011).
Verification of Supervision – Post-Graduate Degree Supervised Experience, LPC Form 2-VS (rev. 2/2011).
Coursework Outline Form, LPC Form 2-CO (rev. 2/2011).
Verification of Internship Hours Towards the Residency, LPC Form 2-IR (rev. 2/2011).
Verification of Internship, LPC Form 2-VI (rev. 2/2011).
Verification of Licensure, LPC Form 2-VL (rev. 2/2011).
Supervision Outline - Examination Applicants Only, LPC Form 2-SO (rev. 2/2011).
Verification of Clinical Practice, 5 of Last 6 Years Immediately Preceding Submission of Application for Licensure, LPC Form-ECP (rev. 2/2011).
Continuing Education Summary Form (LPC) (rev. 3/2009).
Application for Reinstatement of a Lapsed License (rev. 8/2007).
Application for Reinstatement of a Revoked, Suspended, or Surrendered License (rev. 8/2007).
Application for Board Approved LPC, LMFT and LSATP Supervisor (rev. 2/2020).
Quarterly Evaluation for LPC Licensure(rev. 12/2019).
Licensure Verification of Out-of-State Supervisor(rev. 12/2019).
Application for a License to Practice as a Licensed Professional Counselor by examination or endorsement, online form available at https://www.license.dhp.virginia.gov/apply/.
Verification of Supervision for LPC Licensure (rev. 12/2019).
Verification of Required Coursework and Internship for LPC Licensure (rev. 12/2019).
Doctoral Verification of Supervised Internship/Practicum Hours Toward LPC Licensure (rev. 10/2019).
Verification of Degree and Internship for LPC Licensure (rev. 12/2019).
Request for Verification of Virginia Counseling License/Certification/Registration (rev. 5/2018).
Supervision Summary Form for LPC Licensure (rev. 12/2019).
Verification of Clinical Independent Practice as a Licensed Professional Counselor for 24 of the Last 60 Months Immediately Preceding Submission of Application for Licensure (rev. 04/2018).
Continuing Education Summary Form (LPC) (rev. 09/2019).
Application for Reinstatement of a LPC, LMFT, LSATP (rev. 4/2018).
Application for Reinstatement of a LPC, LMFT, LSATP Following Revocation or Suspension (rev. 4/2018).
VA.R. Doc. No. R21-6623; Filed January 05, 2021