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Forms

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NOTE: Our system will allow you to upload the following types of files: GIF, BMP, TIF, JPG, and PDF ONLY.

LCMHCA New Applicant Forms

Here you will find all forms related to LCMHCA.

LCMHCA Current Licensee Forms (To be completed by the supervisor and supervisee)

Here you will find all forms related to LCMHCA.

A Supervision Contract must be completed using the Supervision Contract form provided by the Board. LCMHCAs must receive approval of supervision contract prior to rendering counseling services. Notifications of approvals (or denials) are sent to the Supervisor. Contracts are usually reviewed within 2 weeks of receipt.

LCMHC Forms

Here you will find all forms related to LCMHC.

LCMHCS New Applicant Forms

Here you will find all forms related to LCMHCS.

LCMHCS Current Licensee Forms (To be completed by the supervisor)

Here you will find all forms related to LCMHCS.

LCMHC by Endorsement Forms

Here you will find all LCMHC by endorsement forms.

LCMHC By Reciprocity Forms (To be completed by the verifier)

Here you will find all reciprocity forms.

Administrative Forms

Here you will find all administrative forms.

You can submit your name change request through the portal and submit documentation to one of the email addresses below. (Licensee's must provide a copy of their ID (Driver's license, SSN card) showing new legal name and one of the required documents on the form, the forms can be emailed to LCMHCinfo@ncblcmhc.org or mailed in color to PO Box 77819, Greensboro, NC 27417 (faxes are not accepted).

Complaint Form

Here you will find all Complaint form.

Corporation Forms

Here you will find all corporation forms.