Section 24-6-4-2 - Initial Application for Provisionally Certified Mental Health Therapist (PCMHT)A. Application Packet Upon reading the requirements for professional credentialing in Chapter 3, Section 2, pp. 8-10, and making a decision to apply for Provisionally Certified Mental Health Therapist (PCMHT), an individual shall submit to the Division an application packet containing the forms/materials listed below. These forms verify the provisional certification requirements listed in Chapter 3, Section 2, pp. 8-10.
(1) Application: A completed, notarized Application Form;(2) Employment: A completed Verification of Employment Form from the applicant's current place of employment meeting the employment requirement listed in Chapter 3, Section 2, C., (1), p. 9;(3) Education: An Official Transcript(s) meeting the educational requirements listed in Chapter 3, Section 2, C., (2), p. 9;(4) Experience: A completed Verification of Experience Form(s) meeting the experience requirements listed in Chapter 3, Section 2, C., (3), p. 9; and,(5) Application Fee: A nonrefundable $75.00 check or money order made payable to the Mississippi Department of Mental Health. See Chapter 6, Section 1, A., p. 36 for more information on the Application Fee.B. Directions (1) When preparing to submit an initial application for provisional certification (PCMHT), be sure to follow the General Guidelines found in Chapter 4, Section 1, pp. 19-23 as well as the directions found at the top of each form. Directions are also located in Chapter 9 on p. 47 and in a checklist format found on p. 48.(2) If questions arise which are not addressed in this document, please contact the Division for assistance.24 Miss. Code. R. § 6-4-2