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Ky.gov An Official Website of the Commonwealth of Kentucky
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.

 

 

 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 Licensee or Course Application.pdf
  
219 KB 2/9/2016 11:52 AM
LPCA SEMI-ANNUAL REPORT.doc
  
100 KB 3/31/2015 7:58 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