**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 Bachelor's degree in a health or human services counseling field from an accredited educational institution approved by the Board of Professional Counselors and Therapists OR completion of a program of studies judged by the Board to be substantially equivalent in subject matter and training?
If "yes", please indicate the name of the school where degree was earned, degree type (Master's, Doctoral, etc.), field of study, and the date the degree was earned in the space below. If no, please indicate N/A in the text box.
2
Describe your experience working with substance use disorders, including experience completing substance use disorder assessments and facilitating individual and group counseling sessions with adolescent and/or adult populations.
This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.
3
Describe your experience in crisis intervention. Include place of employment, dates and job duties. If no experience, indicate N/A.
4
Describe your experience implementing trauma-informed care to clients in this particular field.
This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.
5
Do you possess a Maryland Alcohol and Drug Trainee status through the Board of Professional Counselors and Therapists? If YES, please upload copy of trainee letter/certification to application.
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