Forms

 Forms

• AADC Initial Application

• ADA Special Accommodations Request

• ADC Initial Application

• AADC, ADC, CS, CCJP, PSI, PSII Recertification Online Application

• Application for Three Year Approved Provider Status

• Board of Directors Application

• Completed ADA Form Upload

• CCJP Initial Application

• Certification of Truth ADC/AADC Initial Applications Only (notary form)

• Certification of Truth PRSS Initial Applications Only (notary form)

• Certified Family Peer Specialist Affirmation of Truth (notary form)

• Certified Family Peer Specialist Initial Application

• Certified Family Peer Specialist Recertification Application (every 3 years)

• CSPRSS for the Currently WVCBAPP Credentialed PRSS-SUD/MH Track 1 Initial Application

• CSPRSS Currently Credentialed Clinical (no lived experience) Track 2 Initial Application

• CSPRSS for the Currently WVCBAPP Credentialed PRSS-SUD/MH Track 1 Recertification Application

• CSPRSS Currently Credentialed Clinical (no lived experience) Track 2 Recertification Application

• CS Initial Application

• Demographic Record Update Form (name, address update)

• Event Description Form

• Individual Continuing Education Approval Form

• Initial and Recertification Application for Emeritus Status

• Initial Application Substance Use Disorder PRSS FOR CURRENT PRSS-MH Credential Holders

• Initial Application Mental Health PRSS FOR CURRENT PRSS-SUD Credential Holders

• Initial Application Mental Health Peer Recovery Support Specialist

• Initial Application SUD Peer Recovery Support Specialist

• Initial Exam Purchase

• Personal Credit for Providing Training Application

• PSI Initial Application

  PSII Initial Application

• PSI and PSII Affirmation of Truth initial application only (Notary Form)

• PRSS-MH Recertification Application

• PRSS-SUD Recertification Application

• PRSS Supervisor Form (Initial Application Only, Email to Supervisor)

• Reimbursement Request for PRSS SUD and PRSS MH Fees (GRANT)

• Replacement Certificate or Card

• Retesting Request

• Sample ADC/AADC Supervision Goals, Methods, and Log

• Self-Reporting Form

• Status Change Form

• WVCBAPP Ethics Complaint Form