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Forms

​​​​Forms

All forms should be mailed to
125 Holmes Street, Suite 310
Frankfort, Kentucky 40601

For Applications, Renewals, and Continuing Education
DownloadTypeCategory
Application for Continuing Education Credit Approvaldocx 
CE_Individual Application for Continuing Education ApprovaldocCE
CE_Provider Renewal Application for Continuing Education Credit ApprovaldocxCE
CE_Provider-Sponsor Application for Continuing Education ApprovaldocCE
CE_Sponsorship Renewal Application for Continuing Education Credit ApprovaldocxCE
Complaint_Complaint Form and Instructions and ReleasedocComplaints
Licensure_Application and Instructions-2018docLicensure
Licensure_Application InformationdocLicensure
Licensure_Out of State Applicant Instructions and ApplicationdocLicensure
Licensure_Renewal FormdocLicensure
Supervision_Continued Supervision after Clinical Exam Approval ProofdocSupervision
Supervision_Contract for Clinical Social Work SupervisiondocSupervision
Supervision_Notice to ClientdocSupervision
Supervision_Request for Additional SupervisordocSupervision
Supervision_Request to be an Approved SupervisordocSupervision
Supervision_Supervised Experience Documentation FormdocSupervision
Temporary Permit_Application for Temporary Permit to Practice Clinical Social WorkdocTemporary Permit
Temporary Permit_Application for Temporary Permit to Practice Non-Clinical Social WorkdocTemporary Permit
Temporary Permit_Documentation of Supervision for Temporary PermitdocTemporary Permit
Temporary Permit_Request for Additional Supervisor for Non-Clinical Temporary PermitdocTemporary Permit
Update Information_Name or Address Change FormdocName or Address Change

 

​Mail all completed forms to
Kentucky Board of Social Work
125 Holmes Street, Suite 310
Frankfort, Kentucky 40601