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The official website of the State of Mississippi

UROLA APPLICANTS: Review the scope of practice afforded to you by your current license to ensure you are applying for the appropriate license in Mississippi. Applications for licensure beyond your current scope may be denied.

MFT FORMS and LICENSING INFORMATION

These forms are for marriage and family therapy licensure only. Please see the Applications below. 

NEW APPLICANT DOCUMENTS

Quickstep Guide through the LMFT Process <--INFORMATIVE GUIDE

Application to sit for the AMFTRB Exam

LMFTA Application for Licensure including checklist

LMFT Application for Licensure including checklist

LMFT ENDORSEMENT Application including checklist - for licensed MFT out-of-state applicants 

 

NEW APPLICANT AND CURRENT LICENSEE DOCUMENTS

Request for Fingerprint Card - ALL LMFT and LMFTA Applicants must complete this form.

License Verification Request for MS Licensees 

Name Change

Change of Employment for supervision update

Out-of-state License Verification for MFT

Universal Recognition Affidavit - This form cannot be completed until you have been licensed out-of-state for one year.

Verification of Post-Degree Experience in MFT

Professional Reference Form

Documentation of Supervision 

Request for Reconsideration of Board Action Form

 

CURRENT LICENSEE DOCUMENTS

LMFTA Renewal Form

LMFT Renewal Form

MFT Continuing Education Report

MFT Reinstatement Form

Inactive Status Request

Waiver/Extension Request

 

SUPERVISION DOCUMENTS

INFORMATIVE GUIDES and RESOURCES

A Guide to Supervision for Candidate Seeking Licensure as an LMFT

LMFT Board Approved Supervisors

FORMS

MFT Contract for Supervision

MFT Supervisee Evaluation Form

MFT Termination of Supervision Form

Supervisor's Approval Application

Supervisor Statement

Supervised Self-Directed Learning Group Approval 

 

CE Sponsor Application for Approval/Renewal

Approved Sponsor Application for Individual Program

Application for Individual Program for Non-Approved CE Providers