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Kentucky Board of Licensed Professional Counselors

Board of Licensed Professional Counselors
Applications and Forms

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Note: The documents on this page are in Adobe Acrobat (PDF) format. Please click on the following link to download a free copy of Adobe Acrobat Reader.

Please be advised that these documents will allow you to type in your information, print, and mail.  They will not allow you to save your document, so remember to keep a copy for your own files.

 

 Form Library

 
  
  
  
  
Application for Licensure as an LPCA.pdf
  
245 KB 5/10/2012 3:53 PM
Application for Licensure as an LPCC.pdf
  
311 KB 5/10/2012 3:50 PM
Application for Reinstatement - LPCA.pdf
  
38 KB 5/18/2011 2:29 PM
Complaint Form.pdf
  
22 KB 5/18/2011 4:51 PM
Continuing Education Program Application.pdf
  
38 KB 5/18/2011 2:29 PM
LPCA Renewal Form 2014.doc
  
40 KB 8/13/2014 9:24 AM
LPCA SEMI-ANNUAL REPORT.doc
  
102 KB 3/19/2014 2:57 PM
LPCC Renewal Form 2014.doc
  
40 KB 8/13/2014 9:25 AM
Name-Address Change Form.pdf
  
50 KB 12/5/2014 3:37 PM
Open Records Request.pdf
  
35 KB 6/4/2012 9:33 AM
Reciprocity Information Sheet.pdf
  
20 KB 5/18/2011 2:29 PM
Reinstatement Application - LPCC.pdf
  
54 KB 5/18/2011 2:29 PM
Request for Mailing List.pdf
  
103 KB 1/2/2013 1:46 PM
Supervisory Agreement.docx
  
65 KB 3/19/2014 8:08 AM
Verification of Licensure Request.pdf
  
45 KB 5/18/2011 2:29 PM