Forms

  2. Forms

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)

Here you will find all forms related to LCMHCA.

View/Download Supervision Contract Form

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.

Complaint Form

Here you will find all Complaint form.

Disclaimer: All information provided by the North Carolina Board of Licensed Clinical Mental Health Counselors (hereafter “the Board”) on this web site is made available to provide immediate access for the convenience of interested persons. While the Board believes the information to be reliable, human or mechanical error remains a possibility, as does delay in the posting or updating of information. Therefore, the Board makes no guarantee as to the accuracy, completeness, timeliness, currency, or for any errors or omissions, or for the use or results obtained from the use of this information. All access to and use of this web site is governed by the Disclaimers as set forth by the Board.

Mailing Addresses:

For General Mail:
Post Office Box 77819
Greensboro, North Carolina 27417

For Overnight and Special Delivery:
2-C Terrace Way
Greensboro, North Carolina 27403

Contact Information:

For questions please reach us at:
844-622-3572 or 336-217-6007

You can contact us by email at:
LCMHCinfo@ncblcmhc.org

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Copyright ©2020 | North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC)