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Registered Agency Affiliated Counselor Employment Verification Form 2026
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How to Use or Fill Out the Agency Affiliated Counselor Credentialing Form Online
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your name and credential number in the designated fields. Ensure that this information is accurate as it will be used for verification.
- Select your type of agency affiliated counselor by marking all applicable options: Employee, Juvenile Probation Counselor, or Student Intern.
- Indicate whether this is a new application, an update/change, or an additional agency by checking the appropriate box.
- Fill in the date of hire using the MM/DD/YYYY format to ensure clarity.
- Provide the agency or facility employer name and physical address, including city, state, and zip code.
- Confirm that your agency meets the necessary criteria by checking the relevant box regarding its status within Washington State.
- Finally, have the employer or authorized employee sign and date the form before submission.
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Related links
This form will be used to update all active AAC credentials the employee holds. Signature of employer or designated/authorized employee
An applicant for an agency affiliated counselor, An application on forms provided by the department. Employment verification if necessary for the credential;