Forms

HB 1719 Suicide Prevention Training and Education Requirements:

HB 1719 passed this legislative session and the bill includes language requiring all health care professionals to complete two hours of suicide prevention training as a condition of the initial licensure and subsequent renewals. Starting September 30, 2018, the State Committee for Social Workers will require evidence of this training to be included with the initial application for licensure and, beginning with the 2019 renewal period, necessary for license renewal. This course can be completed via self-study or in-person. Attached to the LBSW/LMSW, LCSW and Reciprocity applications you will find a form stating you attest that you completed the minimum of two (2) hours of training in the areas of suicide, assessment, treatment, referrals and management. Failure to do so will delay the processing of your application or renewal.

Continuing Education Rules.

House Bill No. 1719

Suicide Intervention 101 Training flyer 9.12.19

2019 Regional Suicide Prevention Conference Flyer

Beginning May 14, 2019, all licensees beginning their supervision shall use the required Record of Supervision Log Form that is to be filed at the 12, 24, 36 month timeframe of when the Annual Progress Reports are to be due, along with the Attestation Form and Supervision Termination forms below. This form will not be required for those that began supervision toward their Missouri License prior to this date.
Failure to file the Record of Supervision Log Form will delay the processing of your file.
Record of Supervision Log Form (PDF)


Registration of Supervision Process form
Registration of Supervision / Change of Status
Record of Supervision Log Form
Annual Supervision Progress Report- Clinical
Annual Supervision Progress Report- Advanced Macro
Annual Supervision Progress Report- Baccalaureate-Independent Practice

Supervision Change of Status
Supervision Termination
Attestation of Supervised Social Work Experience
Supervisor Brochure

Application for Licensure - LMSW/LBSW
Application for Licensure - LCSW/LAMSW (includes Attestation Form)
Application for Licensure by Reciprocity

Fingerprinting/Background Check Instructions

Professional Disclosure Statement