Form 3236, Licensed Chemical Dependency Counselor Licensure by Reciprocity Application

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Documents

Effective Date: 2/2022

Instructions

Updated: 2/2022

Purpose

Form 3236 is used for individuals licensed or certified as a chemical dependency counselor in another state to apply for licensure as a licensed chemical dependency counselor (LCDC) by reciprocity. For questions on the LCDC Program, email lcdc@hhs.texas.gov.

Information regarding licensure is located on the Texas Health and Human Services website at https://www.hhs.texas.gov/doing-business-hhs/licensing-credentialing-regulation/professional-licensing-certification-unit/licensed-chemical-dependency-counselor-program.

Procedure

When to Prepare

An applicant must submit the application, fee and other documents, and complete all actions as required by Texas Administrative Code Title 25 (25 TAC) Chapter 140, Licensed Chemical Dependency Counselors, §140.414 LCDC Licensure Through Reciprocity.

The Texas Health and Human Services Commission (HHSC) must approve all required application materials received before HHSC will issue a license to the applicant.

An applicant must meet the all eligibility criteria under 25 TAC §140.414.

An applicant must submit the following to HHSC by mail:

  • A completed signed, dated and notarized Form 3236, as required by 25 TAC §140.414(a)(2).
  • A recent full-face wallet sized photo (2.5" by 3.5"), as required by 25 TAC §140.414(a)(4) attached to Form 3236.
  • A total application fee of $150, as required by 25 TAC §140.414(a)(6) and 25 TAC §140.403(a).
  • Two letters of recommendation, as required by 25 TAC §140.414(a)(5).
  • A receipt for two sets of fingerprints necessary 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 §140.431.
  • A copy of the applicant's reciprocal license or certification with verified information from the issuing authority as to any disciplinary history against the applicant, as required by 25 TAC §140.414(a)(1).
    • Verified information may include a license verification or a letter from the issuing authority stating the applicant's license is in good standing.
  • An official college transcript showing the applicant holds an associate degree or more advanced degree, as required by 25 TAC §140.414(a)(8).
  • Proof of the applicant's successful completion of a licensing examination approved by HHSC, as required by 25 TAC §140.414(a)(7).

Important Items to Note:

  • HHSC will not process an application before receiving the required $150 fee. Make checks for all license fees payable to Texas Health and Human Services Commission. License fees are not refundable.
  • Fingerprint Applicant Services of Texas (FAST) processes fingerprints for both required background checks. HHSC will send an applicant a FAST Fingerprint Pass form after HHSC receives the applicant's application and fee. Applicants must follow the instructions on this form to submit their fingerprints. Email lcdc@hhs.texas.gov the receipt from IdentoGo. Do not submit a fingerprint card with Form 3236.
  • HHSC must receive college transcripts directly from the school. The school may send the transcript by email to lcdc@hhs.texas.gov or U.S. mail to:

    Texas Health and Human Services
    Mail Code 1982
    Texas Health and Human Services
    Mail Code 1982

Mailing Address for Application with Fee:

HHSC ARTS, Mail Code 1470
P.O. Box 149055
Austin, Texas 78714-9055