Follow the steps to successfully complete your CTI application online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select whether you are submitting a new application or a renewal application by checking the appropriate box at the top of the form. If renewing, include your previous permit number.
3. Fill in the organization information section. Include the name of the organization (including any doing business as name), mailing address, city, state, ZIP code, telephone number, fax number, and facility license number.
4. Indicate your exempt status if applicable. Provide the number of qualified counseling professionals (QCCs) on staff.
5. Describe the services provided where interns will be placed. Be thorough and clear to ensure compliance with application requirements.
6. Complete the CTI Coordinator information section. Print the name, license type and number, title, and signature of the CTI Coordinator. Include the date of signature.
7. Ensure that all necessary attachments are included with your application, such as proof of registration, the signed ethical agreement form, and a written outline of reading assignments and training activities based on knowledge, skills, and attitudes (KSA).
8. After completing all sections and ensuring all attachments are included, review the form for accuracy before submitting. You will have options to save changes, download, print, or share the completed form.

Ready to complete your application? Start filling out the Clinical Training Institution (CTI) Application Form online today.