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

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Documents

Effective Date: 2/2024

Instructions

Updated: 11/2023

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.

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, Section 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 Section 140.405.

An applicant must submit all the following to HHSC:

  • The following in accordance with 25 TAC Section 140.404(a):
    • 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 Section 140.404(a)(1)  and 25 TAC Section 140.403(a).
      • Please do not separate the payment. The check or money order must be in the amount of $65.00.
  • An IdentoGo receipt for two sets of fingerprints, which is 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 Section 140.431.
  • The following in accordance with 25 TAC Section 140.405:
    • 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 chemical dependency; or
    • an official college transcript showing an approved degree, which exempts the applicant from the education and practicum requirements.
      Note: HHSC must receive an official college transcript in a sealed envelope from the applicant’s school. Either the applicant may request an official college transcript from the school and include the sealed transcript in their application or the school may send the transcript separately by email to lcdc@hhs.texas.gov or U.S. mail to:

      HHS LCDC, Mail Code 1982
      P.O. Box 149347
      Austin, Texas 78714-9347
       

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 Section 140.413.

An applicant must submit to HHSC:

  • The following in accordance with 25 TAC Section 140.413(2):
    • A completed signed, dated and notarized Form 3248.
    • A recent full-face wallet sized photo (2.5" by 3.5") attached to Form 3248.
    • The initial LCDC application fee of $25.00 and background investigation fee of $40.00, as required by 25 TAC Section 140.404(a)(1) and 25 TAC Section 140.403(a)(4).
      • Please do not separate the payment. The check or money order must be in the amount of $65.00.
  • An IdentoGo receipt for two sets of fingerprints, which is 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 Section 140.431.

Mailing Address for Applications with Fees:

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

Note: Mailing the application and fees to an address other than the one listed above will result in a delay in the processing of the application.