Behavioral Sciences Regulatory Board
 



Forms
___________________________________________________________________
Home > Forms
 

Note to the viewers of this page:

Information on this page is provided in Adobe Reader Format (.pdf). Please visit Adobe.com to get the necessary plug-ins to view these documents if you do not already have them.

- General Forms
- Psychology Forms
- Social Work Forms
- Professional Counselor Forms
- Master Level Psychology Forms
- Marriage & Family Therapy Forms
- Addiction Counselor Forms

General Forms

- Complaint Form - (pdf)

- Mailing Labels Order Form - (pdf)

- Billfold Card Replacement - (pdf)

- Wall Certificate Replacement - (pdf)

- CEU Provider Application - (pdf)

- Credit Card Form - (pdf)

Psychologists

- LP Application - (pdf)

- LP Reciprocity Application - (pdf)

- LP Renewal - (pdf)

- Audit Packet - (pdf)

- LP Reinstatement - (pdf)

- Out-Of-State Permit - (pdf)

- Credit Card Form - (pdf)

Social Workers

- LBSW & MSW Application - (pdf)

- LSCSW Application - (pdf)

- SW Reciprocity Application - (pdf)

- SW Renewal - (pdf)

- Audit Packet - (pdf)

- SW Reinstatement - (pdf)

- Out-Of-State Permit - (pdf)

- Credit Card Form - (pdf)

- LSCSW Supervision Training Plan - (pdf)

- LSCSW Training Plan Amendment (Supervisor) - (pdf)

- LSCSW Training Plan Amendment (Work) - (pdf)

Professional Counselors

- LPC Application - (pdf)

- LCPC Application - (pdf)

- LPC & LCPC Reciprocity Application - (pdf)

- LPC & LCPC Renewal - (pdf)

- Audit Packet - (pdf)

- LCPC & LPC Reinstatement Application - (pdf)

- Out-Of-State Permit - (pdf)

- Transition Application - (pdf) (Use only if licensed before August 2000)

- Credit Card Form - (pdf)

- LCPC Supervision Training Plan - (pdf)

- LCPC Training Plan Amendment (Supervisor) - (pdf)

- LCPC Training Plan Amendment (Work) - (pdf)

Master Psychologists

- LMLP Application - (pdf)

- LCP Application - (pdf)

- LMLP & LCP Reciprocity Application - (pdf)

- LMLP & LCP Renewal - (pdf)

- Audit Packet - (pdf)

- LCP & LMLP Reinstatement Application - (pdf)

- Out-Of-State Permit - (pdf)

- Transition Application - (pdf) (Use only if licensed before August 2000)

- Credit Card Form - (pdf)

- LCP Supervision Training Plan - (pdf)

- LCP Training Plan Amendment (Supervisor) - (pdf)

- LCP Training Plan Amendment (Work) - (pdf)

Marriage & Family Therapists

- LMFT Application - (pdf)

- LCMFT Application - (pdf)

- LMFT & LCMFT Reciprocity Application - (pdf)

- LMFT & LCMFT Renewal - (pdf)

- Audit Packet - (pdf)

- LCMFT & LMFT Reinstatement - (pdf)

- Out-Of-State Permit - (pdf)

- Transition Application - (pdf) (Use only if licensed before August 2000)

- Credit Card Form - (pdf)

- LCMFT Supervision Training Plan - (pdf)

- LCMFT Training Plan Amendment (Supervisor) - (pdf)

- LCMFT Training Plan Amendment (Work) - (pdf)

Addiction Counselors

- LAC Grandparenting Application - (pdf)

- LCAC Grandparenting Application - (pdf)

- LAC Application - (pdf)

- LCAC Application - (pdf)

- LAC by BSRB Masters Level License - (pdf) (Must hold LMLP, LMSW, LPC or LMFT in KS to use this application)

- LCAC By BSRB Clinical Application - (pdf) (Must hold LP, LSCSW, LCPC, LCP, or LCMFT in KS to use this application)

- LAC Reciprocity Application - (pdf)

- LCAC Reciprocity Application - (pdf)

- LAC/LCAC Renewal - (pdf)

- Audit Packet - (pdf)

- LAC/LCAC Reinstatement - (pdf)

- Credit Card Form - (pdf)

- LCAC Supervision Training Plan - (pdf)

 

 

Copyright © 2009 Behavioral Sciences Regulatory Board
700 S.W. Harrison St, Ste 420- Topeka, KS 66603-3929 phone: 785-296-3240 - fax: 785-296-3112
home | site search | forms | professions | publications | website policy | contact us