Form 3248, Chemical Dependency Counselor Intern Registration Application – Licensure by Exam with Degree or Internship

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Effective Date
05/2022
3248.pdf (216.28 KB)

Instructions

Updated: 5/2022

Purpose

Form 3248 is used to apply for registration as a licensed chemical dependency counselor intern (LCDC-I). 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, fees and other documents and complete all actions as required by Texas Administrative Code (TAC) Title 25, Chapter 140, Licensed Chemical Dependency Counselors, §140.404, LCDC Licensure Application Standards and Counselor Intern Registration.

The Texas Health and Human Services Commission (HHSC) must review and approve all required application materials received before HHSC will register the applicant as an LCDC-I.

Initial Registration

An applicant must meet all the eligibility criteria under 25 TAC §140.405.

An applicant must submit the following in accordance with 25 TAC §140.404(a) to HHSC:

  • A completed, signed, dated and notarized Form 3248;
  • A recent full-face wallet sized photo (2.5" by 3.5") attached to Form 3248;
  • Application fee of $25.00 and background investigation fee of $40.00, as required by 25 TAC §140.404(a)(1) and 25 TAC §140.403(a);
  • 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; and
  • Documentation showing the applicant meets the requirements in 25 TAC §140.405, including one of the following:
    • An official college transcript (no photocopies) documenting the applicant completed 270 classroom hours and 300 hours of approved supervised field work practicum with a letter from the school’s educational coordinator or chair stating the applicant's completed practicum was in the field of substance abuse; or
    • An official college transcript showing an approved degree, which exempts the applicant from the education and practicum requirements in accordance with 25 TAC §140.405(b).

Subsequent Registration

To re-register as a counselor intern after an LCDC-I’s counselor intern registration expires, an applicant must meet the requirements for subsequent registration under 25 TAC §140.413.

An applicant must submit the following in accordance with 25 TAC §140.413(2) to HHSC:

  • A completed signed, dated and notarized Form 3248;
  • A recent full-face wallet sized photo (2.5" by 3.5") attached to Form 3248;
  • A college transcript documenting the required 12 semester hours or 18 quarter hours of course work, related to chemical dependency counseling, psychology, sociology, counseling, mental health, behavioral science, psychiatric nursing, ethics or rehabilitation counseling, at a career school or college or an accredited institution of higher education;
  • 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; and
  • The initial LCDC application fee of $25.00 and background investigation fee of $40.00, as required by 25 TAC §140.404(a)(1) and 25 TAC §140.403(a)(4).

Mailing Address for Applications with Fees:

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