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#20-002003-0006
Supplemental Questionnaire

Last Name
First Name
1

 Are you currently licensed as an LMSW in Maryland?  If not, please list when you would be eligible to take the LMSW examination and have you scheduled the examination?

2

Describe your work experience providing forensic social work services.

3

Describe your experience conducting screening interviews and assessments and developing treatment plans.

4

Describe your background in Behavioral Health including experience working with clients with co-occurring disorders or other complex behavioral health needs.


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