Form 3233, Licensed Chemical Dependency Counselor Program Request for Criminal History Evaluation

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Effective Date: 10/2022


Updated: 12/2023


Form 3233 is used to obtain a criminal history check from both the Texas Department of Public Safety and the Federal Bureau of Investigations, as required by 25 TAC Section 140.431. Potential applicants for Chemical Dependency Counselor Intern (LCDC-I) registration may use Form 3233 to check their criminal history prior to applying for LCDC-I registration.

An IdentoGo receipt for two sets of fingerprints must be submitted with Form 3233. Instructions on how to obtain and submit fingerprint receipts to HHSC are included in the LCDC fingerprint instructions document.
For questions on the LCDC Program, email

Information regarding licensure is located on the Texas Health and Human Services website.