REGULATIONS
Vol. 37 Iss. 13 - February 15, 2021

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF SOCIAL WORK
Chapter 20
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: 18VAC140-20. Regulations Governing the Practice of Social Work.

Effective Date: February 15, 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.

Summary of Public Comments and Agency's Response: No public comments were received by the promulgating agency.

FORMS (18VAC140-20)

Verification of Clinical Supervision (rev. 8/2016)

Request for Termination of Supervision (rev. 11/2015)

Request for Termination of Supervision (rev. 2/2020)

Application for Initial and Add or Change Registration of Supervision toward LCSW licensure, online form available at https://www.dhp.virginia.gov/social/social_forms.htm

Application for Licensure by Examination and Endorsement as a Licensed Clinical Social Worker, online form available at https://www.dhp.virginia.gov/social/social_forms.htm

Electronic Application Instructions for Licensure by Examination as a Licensed Baccalaureate Social Worker (LBSW) (rev. 8/2019)

Electronic Application Instructions for Licensure by Endorsement as a Licensed Baccalaureate Social Worker (LBSW) (rev. 8/2019)

Electronic Application Instructions for Licensure by Examination as a Licensed Master's Social Worker (LMSW) (rev. 8/2019)

Electronic application instructions for Licensure by Endorsement as a Licensed Master's Social Worker (LMSW) (rev. 8/2019)

Electronic Application Instructions for Licensure by Examination as a Licensed Clinical Social Worker (LCSW) (rev. 8/2019)

Electronic application instructions for Licensure by Endorsement as a Licensed Clinical Social Worker (LCSW) (rev. 8/2019)

Instructions and Application for Registration of Supervision for LSW (rev. 9/2015)

Reinstatement Application for LCSW, LMSW, LBSW (rev. 12/2013)

Reinstatement Following Disciplinary Action for LCSW, LMSW, LBSW (rev. 12/2013)

Social Work Name-Address Change Form (rev. 5/2018)

Request for Inactive Status of Current Social Work License (rev. 7/2017)

Request for Change of Status - Inactive to Active (rev. 7/2017)

Request for Verification of Virginia License (rev. 7/2017)

Request for Late Renewal (rev. 6/2017)

Application for Licensure by Examination and Endorsement as a Licensed Baccalaureate Social Worker, online form available at https://www.dhp.virginia.gov/social/social_forms.htm

LCSW Supervision Log (rev. 3/2020)

Application for Reinstatement of Licensure: Checklist Instructions (rev. 3/2020)

Application for Reinstatement Following Disciplinary Action: Checklist Instructions (rev. 3/2020)

Social Work Name/Address Change (rev. 2/2020)

Request for Change in Status of Virginia Social Work License (Current Active to Current Inactive) (rev. 3/2020)

Request for Change in Status of Virginia Social Work License (Current Inactive to Current Active) (rev. 3/2020)

Request for Verification of Virginia Social Work License (rev. 2/2020)

Request for Late Renewal Instructions (rev. 3/2020)

VA.R. Doc. No. R21-6670; Filed January 24, 2021