Publications
These directions provide a general explanation of the information that you need to add to sections of the form.
Complete and return the license application form with the required attachments. For an initial registration to be complete, all of the required information must be included. An incomplete and incorrect application will result in the return of your application and possible denial.
DCFLC 2014 Strategic Recommendations and Financial Literacy Implementation Report
This form is designed to authorize the disclosure of mental health information listed below by the individual practitioner to determine entitlement of paymant of claims or reimbursement. It is not to be used for in-patient or partial hospitalization.