Virginia lpc licensure 2026

1. Click ‘Get Form’ to open the Virginia LPC Licensure evaluation form in the editor.
2. Begin by entering your name in the 'Name of Applicant' field, followed by your email address. Ensure accuracy as this information is crucial for communication.
3. In the 'Supervisor’s Evaluation' section, your supervisor should fill in their name and license details. This includes their license number and type, which are essential for validation.
4. Provide the business name and address of your residency work site where clinical hours were obtained. Make sure to specify only one location.
5. Fill in the dates of supervision, including both start and end dates. Indicate hours per week worked and ensure all columns are completed accurately.
6. Answer the questions regarding face-to-face client contact hours and supervision received. Be honest and thorough in your responses.
7. Finally, have your supervisor sign and date the form at the bottom to validate it before submission.

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