Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.
1
Do you possess a current license as a Licensed Clinical Alcohol and Drug Counselor (LCADC) from the Maryland Board of Professional Counselors and Therapists?
Yes
No
2
If you answered Yes to the previous question, please provide the license number and expiration date in the box below. A copy of your current license or license verification should also accompany your application.
3
Describe your experience providing counseling to clients with substance use disorders by using assessment, evaluation, intervention, treatment and rehabilitation.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
4
Do you possess approval from the Board of Professional Counselors and Therapists to supervise substance abuse counselors? If yes, please upload a copy of your approval with your application.
Yes
No
5
Describe your supervisory experience. Please describe in detail your experience, including the name of your employers, dates of employment and hours worked per week in the box below. If you do not have this type of experience, please write N/A.
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