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Clinical Substance Abuse Counselor - Application Forms

Application for Original Certification
Form # Title/Description
2743 Application for Substance Abuse Counselors
2749  Affidavit Regarding Supervised Experience
2752 Instructions for Substance Abuse Counselor Application
2252  Convictions and Pending Charges "NEW" This document is in a fillable format. If applicable, Please print, sign, and return with application materials to the Department.
2751  Education and Training Form
2868  ICRC Exam Registration Instructions
 
Application for Out of State Reciprocity
Form # Title/Description
2786  Application for Out of State Reciprocity Clinical Substance Abuse Counselor 
2785  Instructions for Out of State Reciprocity Clinical Substance Abuse Counselor Application 
2252  Convictions and Pending Charges "NEW" This document is in a fillable format. If applicable, Please print, sign, and return with application materials to the Department.

Other Information/Forms

Clinical Substance Abuse Counselor- Certification Information