Vol. 37 Iss. 12 - February 01, 2021

Chapter 60

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: 18VAC115-60. Regulations Governing the Practice of Licensed Substance Abuse Treatment Practitioners.

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

FORMS (18VAC115-60)

Licensure Application, Licensed Substance Abuse Treatment Practitioner, LSATP Form 2 (rev. 1/2011).

Verification of Licensure, Form LSATP 2-VL (rev. 1/2011).

Verification of Supervision – Post Graduate Degree Supervised Experience, LSATP 2-VS (rev. 1/2011).

Supervisor's Experience and Education (rev. 1/2011).

Licensure Verification of Out-of-State Supervisor, LSATP Form 1-LV (rev. 1/2011).

Coursework Outline Form, Form LSATP 2-CO (rev. 1/2011).

Verification of Internship, Form LSATP 2-VI (rev. 1/2011).

Verification of Internship Hours Towards the Residency, Form LSATP 2-IR (rev. 1/2011).

Registration of Supervision – Post Graduate Degree Supervised Experience, LSATP Form 1 (rev. 1/2011).

Quarterly Evaluation Form, LSATP Form 1-QE (rev. 1/2011).

Supervision Outline Form – Examination Applicants Only, Form LSATP 2-SO (rev. 1/2011).

Verification of Post-Licensure Clinical Practice, Endorsement Applicants Only, Form LSATP-ECP (rev. 1/2011).

Licensed Substance Abuse Treatment Practitioner Application for Reinstatement of a Lapsed Certificate (rev. 7/2011).

Continuing Education Summary Form (LSATP) (rev. 3/2009).

Application Instructions for Pre-Review of Education Toward LSATP Licensure (rev. 12/2019)

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

Applicant Out-of-State Licensure Verification/Certification (rev. 12/2019)

Verification of Supervision for LSATP Licensure (rev.12/2019)

Application for Board Approved LPC, LMFT and LSATP Supervisor (rev.2/2020)

Licensure Verification of Out-of-State Supervisor (rev. 12/2019)

Verification of Required Coursework and Internship for LSATP Licensure (rev. 12/2019)

Verification of Degree and Internship for LSATP Licensure (rev.12/2019)

Termination of Supervision for a Licensed Resident (rev. 12/2019)

Quarterly Evaluation For LSATP Licensure (rev 12/2019)

Supervision Summary Form for LSATP Licensure(rev.12/2019)

Verification of Clinical Practice for 24 of the Last 60 Months in Substance Abuse Treatment Services Immediately Preceding Submission of Application for Licensure (rev. 4/2018)

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)

Continuing Education Summary Form for LSATP (rev. 9/2019)

Resident in Substance Abuse Treatment Supervisory Contract (sample)

VA.R. Doc. No. R21-6620; Filed January 05, 2021