Administrative Code

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Virginia Administrative Code
Title 18. Professional And Occupational Licensing
Agency 115. Board Of Counseling
Chapter 20. Regulations Governing the Practice of Professional Counseling
10/27/2021

FORMS (18VAC115-20).

Registration of Supervision - Post Graduate Degree Supervised Experience, LPC Form 1 (rev. 2/2011)

Quarterly Evaluation, LPC Form 1-QE (rev. 2/2011)

Licensure Verification of Out-of-State Supervisor, LPC Form 1-LV (rev. 2/2011)

Licensure Application, LPC Form 2 (rev. 2/2011)

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

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

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

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

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

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

Verification of Clinical Practice, 5 of Last 6 Years Immediately Preceding Submission of Application for Licensure, LPC Form-ECP (rev. 2/2011)

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

Application for Reinstatement of a Lapsed License (rev. 8/2007)

Application for Reinstatement of a Revoked, Suspended, or Surrendered License (rev. 8/2007)

Application Instructions for Temporary Licensure as a Resident in Counseling (rev. 12/2019)

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