Get Reset Form Application For Licensure As A Clinical Addiction Counselor (lcac) Behavioral Health And

Filling out the Reset Form Application for Licensure as a Clinical Addiction Counselor (LCAC) is an essential step for those seeking to work professionally in the field of behavioral health. This guide provides clear, comprehensive instructions to help you successfully complete the form online.

Follow the steps to accurately complete your application.

1. Click the ‘Get Form’ button to obtain the application form and open it in your preferred document editor.
2. Begin by entering your personal information in the 'Applicant Information' section, including your full name, current and permanent addresses, contact numbers, email address, and social security number. Your social security number is required for processing your application.
3. Indicate whether you are applying for a temporary permit and specify how you want your name to appear on your licensure.
4. Fill out the 'Graduate Education' section by listing your relevant academic institutions, dates attended, and degrees earned. Make sure to include all pertinent information accurately.
5. Complete the 'Other State Licensure / Certification' section if applicable, detailing any licenses or certifications held in other states.
6. Answer all questions in the 'All Applicants Must Answer the Following Questions' section truthfully. If applicable, provide detailed explanations in a signed and notarized statement.
7. Before signing your application, read through the 'Application Affirmation' section and ensure that all information provided is truthful and complete.
8. Complete the 'Authorization for Release of Information' section to consent to any necessary verifications.
9. After filling out the entire form, review it thoroughly for accuracy. Once satisfied, you can save your changes, download the completed form, and print it out for submission.
10. Submit the completed application form along with any required attachments to the Professional Licensing Agency at the specified address.

Take the next step in your career by completing the Reset Form Application for Licensure as a Clinical Addiction Counselor online today.