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Lmhca indiana application 2012 form

Lmhca indiana application 2012 form-2025

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The document is an application form for licensure as a Mental Health Counselor Associate (LMHCA) in Indiana. It includes sections for personal information, educational background, verification of graduate coursework, and details about required practicum and internship experiences. The form also requires applicants to disclose any prior licenses, disciplinary actions, or legal issues related to their professional history. Additionally, it emphasizes the necessity of providing supporting documentation and authorizations for the release of information.

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Click ‘Get Form’ to open the lmhca indiana application 2012 form in our editor.
Begin by filling out the 'Applicant Information' section. Enter your full name, current and permanent addresses, and contact numbers. Ensure accuracy as this information is crucial for processing your application.
Next, provide your Social Security number as required. Remember, this is mandatory for the application to be processed.
In the 'Graduate Education' section, list your academic institutions and degrees earned. Be sure to include dates attended and program titles.
Complete the 'Other State Licensure/Certification' section if applicable. List any licenses held in other states along with their details.
Affirm the accuracy of your statements by signing in the 'Application Affirmation' section and date it accordingly.
Finally, review all entries for completeness before saving or exporting your filled form for submission.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (37 Votes)
2013	4.4 Satisfied (592 Votes)
2012	4.4 Satisfied (45 Votes)

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How do you qualify for LCAC in Indiana?

As soon as youve graduated from your masters program, you can apply for your LSW license with the Indiana Licensing Board. Fill out the state application here. Part of the application includes a criminal background check, submission of school transcripts, passport photo, and a $50 application fee.

How many hours do you need for Lmhca to LMHC in Indiana?

To qualify for licensure as an LMHCA and subsequently an LMHC, you need to complete a practicum and internship. Your practicum must be at least 100 hours and include at least 40 hours of direct service with clients. Your internship must be at least 600 hours and include at least 66 hours of face-to-face supervision.