Virginia Department of Health Professions Forms
The Virginia Department of Health Professions is responsible for ensuring the safety and welfare of the public in the healthcare field. They regulate and license various healthcare professionals in Virginia, such as doctors, nurses, pharmacists, and other healthcare providers. The department also investigates complaints against healthcare professionals and takes appropriate disciplinary action when necessary. Overall, they aim to protect the health and well-being of the people of Virginia by ensuring that healthcare professionals meet the required standards and operate within the state's laws and regulations.
Documents:
144
This form is used for verifying the license of a medical professional in the state of Virginia.
PDF 
Word
This document is for individuals in Virginia who need to apply for temporary license reinstatement or reactivation in response to the Covid-19 pandemic under Executive Order #51.
This document is used for verifying the supervised experience of a Qualified Mental Health Professional - Child (QMHP-C) in the state of Virginia.
This Form is used for applying to have your QMHP-A or QMHP-C registration reinstated after it has been revoked or suspended in Virginia.
This form is used for requesting reinstatement of a Registered Professional Reporter (RPRS) registration in Virginia after it has been revoked or suspended.
This document is for reinstating the Qualified Mental Health Professional - Child (QMHP-C) certification in Virginia.
This form is used for verifying the internship or practicum of a Qualified Mental Health Professional (QMHP) in the state of Virginia.
This document is used for verifying supervised experience of a Qualified Mental Health Professional - Adult (QMHP-A) in the state of Virginia.
This document is used for applying for the reinstatement of a RPRS registration in the state of Virginia.
This document is for the reinstatement of a Qualified Mental Health Professional - Adult (QMHP-A) in the state of Virginia. It outlines the process and requirements for individuals who were previously certified as QMHP-As and want to regain their certification.
This document is used to verify the supervision of a Certified Substance Abuse Counselor (CSAC) in the state of Virginia.
This Form is used for verifying didactic training for Csac Certification in Virginia.
This form is used for requesting verification of a counseling license, certification, or registration in the state of Virginia. It is necessary when applying for employment, credential transfer, or licensure in another jurisdiction.
This document is used for verifying the licensure or certification of an out-of-state supervisor in Virginia. It ensures that the supervisor meets the necessary qualifications to supervise individuals in their profession.
This form is used to verify an applicant's out-of-state licensure for the state of Virginia. It is necessary for individuals who are licensed in another state and wish to obtain a license in Virginia.
This type of document is used to add or change the registration of supervision for a Certified Substance Abuse Counselor (CSAC) in the state of Virginia.
This form is used for verifying work experience gained while under supervision in the state of Virginia. It is necessary for individuals to demonstrate their experience in order to meet certain professional requirements or obtain licensure in certain fields.
This form is used for reinstatement of a Csac or Csac-A license following revocation or suspension in the state of Virginia.
This document provides information about the didactic training required for the CSAC-A certification in Virginia.
This document is used for verifying the licensure of an out-of-state supervisor in Virginia. It ensures that the supervisor meets the necessary requirements to provide supervision in the state.
This document is used for quarterly evaluation of individuals seeking Lpc licensure in Virginia. It helps assess their progress and eligibility for licensure.
This document is an application form used to apply for the Certified Substance Abuse Counselor Assistant (CSAC-A) exam in the state of Virginia.
This Form is used for summarizing supervision for LPC licensure in the state of Virginia.
This document is used to verify the supervised internship/practicum hours completed by a doctoral student towards obtaining a Licensed Professional Counselor (LPC) license in the state of Virginia.
This form is used for verifying the clinical independent practice of a Licensed Professional Counselor in Virginia for a specific time period.
This document is used for verifying a degree and internship for obtaining an LPC (Licensed Professional Counselor) licensure in the state of Virginia.
This document is used for terminating the supervision of a licensed resident in the state of Virginia. It signifies the end of the monitoring and oversight of the resident's activities.
This form is used for applying to become a Board Approved Csac and Csac-A Supervisor in the state of Virginia.
This form is used for applying to become a supervisor for Licensed Professional Counselors (LPC), Licensed Marriage and Family Therapists (LMFT), and Licensed Substance Abuse Treatment Practitioners (LSATP) in the state of Virginia.
This document verifies the clinical practice of a person working in substance abuse treatment services in Virginia. It confirms that the person has worked in this field for a specified period of time prior to their application for licensure.
This form is used for conducting a quarterly evaluation for individuals seeking LSATP licensure in the state of Virginia. It helps assess the progress and readiness of applicants for licensure in the field of substance abuse treatment.
This document is used for verifying degree and internship for LSATP licensure in the state of Virginia. It ensures that candidates have the required educational qualifications and practical experience for obtaining a license as a Licensed Substance Abuse Treatment Practitioner.
This form is used for summarizing supervision activities for individuals applying for Licensure as a Substance Abuse Treatment Practitioner (LSATP) in Virginia.
This form is used for applying to become a certified rehabilitation provider in Virginia.
This document is used for verifying supervision for LPC licensure in the state of Virginia.
This Form is used for applying to reinstate a Lpc, Lmft, Lsatp license in Virginia after it has been revoked or suspended.
This document is used for verifying the experience of individuals applying for rehabilitation provider certification in the state of Virginia. It ensures that the applicants have the necessary qualifications and experience to practice in the field of rehabilitation.
This document is used for verifying the clinical independent practice experience of a Licensed Marriage and Family Therapist in Virginia for a specific period of time.
This Form is used for rehabilitation providers in Virginia who are seeking reinstatement.
This form is used for verifying the degree and internship of individuals who are applying for LMFT licensure in Virginia. It ensures that the applicant has completed the necessary educational and practical requirements to become a licensed marriage and family therapist in the state.
