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OFFICE OF THE PROFESSIONS



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 * COVID-19
 * Online Services
 * Registration
 * Professions
 * NYS Boards
 * Enforcement
 * Corporate Entities
 * Verification
 * Career Path
 * How Do I


SOCIAL WORK

 * Laws, Rules, & Regulations
 * Verifications
 * Consumer Information
 * Contact Information
 * Corporate Practice Waivers
 * License Statistics
 * Practice Alerts & Guidelines
 * Continuing Education
 * Child Abuse Training
 * FAQs
 * Board Members Only
 * Temporary Exemption from Licensure
 * Professional Assistance Program
 * Waiver Entities
   * Alphabetical Listing of Entities
   * Application for Waiver
   * FAQs


LICENSED MASTER SOCIAL WORKER

 * License Requirements
 * How to Apply
 * Application Forms


LICENSED CLINICAL SOCIAL WORKER

 * License Requirements
 * How to Apply
 * Application Forms
 * "R" Psychotherapy Privilege

NYSED / OP / Professions / Social Work / LMSW Application Forms

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LMSW APPLICATION FORMS

Important Notice: DO NOT use Form 1 if you are already licensed in this
profession in New York State. A New York State professional license is valid for
life unless it is revoked, annulled, or suspended by the Board of Regents. To
practice in New York State, your professional license must be registered. To
renew your registration online, visit www.op.nysed.gov/renewalinfo.htm. If your
registration has lapsed for longer than 4 months, submit a Delayed Registration
Application.

Note: For fillable PDF forms, Internet Explorer is the recommended browser.

Applicant Checklist ( 80 KB) You may print and keep this checklist as a reminder
of what forms you need to file. This is for your reference and should not be
submitted with your application forms. You should also keep a copy of all
application forms submitted.

Online Form 1 - Application for Licensure All applicants for licensure must
initially submit Form 1 along with the $294 licensure and first registration
fee. You must answer all questions and provide all information requested unless
otherwise indicated. Failure to accurately complete all required parts of the
application will delay its review. Additional forms below are required based on
the licensure requirements of the profession. Do not use Form 1 to renew your
existing license.

Continuing Your Application
If you have started an application within the past 30 days, and have not yet
completed it, you can use this link to continue your application. You will need
your Application ID, Social Security Number, and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents
or files to include in your previous submission, use this link to upload
additional documentation. You will need your Application ID and Date of Birth.

Change Address or Name You are required to notify us within 30 days of any
address or name changes. Please read the instructions to request this change.

Form 2 - Certification of Professional Education - ( 17 KB) This form must be
submitted directly by the educational institution(s) you attended. The Office of
the Professions will not accept this form if submitted by the applicant.


 * Section I: Complete this section before sending the entire form to your
   school. Be sure to sign and date item 9.
 * Section II: The Registrar must complete this section and return both pages of
   the form in an official school envelope with requested documents directly to
   the Office of the Professions at the address at the end of the form.

If you attended a social work program not registered as licensure-qualifying by
the New York State Education Department, you must also ask your school to submit
an official transcript or marksheets.

Please photocopy this form as needed.

Important Information About Electronic Education Documentation
The Office of the Professions will accept official electronic transcripts and
forms from educational institutions (i.e. colleges/universities) or designated
third-party transcript entities located in the United States or Canada. More
information can be found here.

Form 3 - Verification of Other Professional Licensure/Certification - ( 18 KB)
Complete this form if you hold, or ever held, a license or certificate to
practice any profession* in any jurisdiction.

This form must be submitted directly by the licensing/certifying authority. The
Office of the Professions will not accept this form if submitted by the
applicant.

 * Section I: Complete this section before sending the entire form to the
   licensing/certifying authority of each jurisdiction in which you are or have
   been licensed/certified. Be sure to sign and date item 8.
 * Section II: The licensing/certifying authority must complete this section,
   sign, date and return both pages of the form directly to the Office of the
   Professions at the address at the end of the form.

NOTE: A Form 3 is not required for licenses/certificates issued by the New York
State Education Department. Also, If the certification/verification
documentation provided by a U.S. jurisdictions contains the same information
requested in the Form 3, completion of a Form 3 for that jurisdiction is not
necessary. For certification/verification documentation that does not contain
the same information, a Form 3 will need to be completed for that jurisdiction.

*Profession is defined as professional titles licensed under New York State
Education Law. (See page 2 of the Address/Name Change Form ( 22 KB) for a list
of those titles.)

Important Information About Electronic Verification of Licensure, Certification
and/or Examination
The Office of the Professions (OP) will accept electronic verifications of
licensure, certification and examination completion from other licensing
authorities located in the United States or Canada that meet certain criteria.
More information can be found here.

Online Form 5 - Application for Limited Permit
All applicants for a limited permit must initially submit Form 5 along with the
$70 limited permit fee. You must also submit a Form 5CS - Certification of
Supervisor for Limited Permit and Operating certificate or certificate of
incorporation along with your application.

Continuing Your Application
If you have started an application within the past 30 days, and have not yet
completed it, you can use this link to continue your application. You will need
your Application ID and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents
or files to include in your previous submission, use this link to upload
additional documentation. You will need your Application ID and Date of Birth.

Changes to Supervisors and/or Settings
If you change supervisors and/or settings, or you have to add or remove a
supervisor or setting, after a permit is issued, you must obtain an amended
permit using the Limited Permit Change Form. After changes are processed you
will receive an amended permit. A fee is not required for an amended permit
issued as a result of a change in supervisor or setting. You must also submit a
Form 5CS - Certification of Supervisor for Limited Permit for each new
supervisor you are adding (see Upload Additional Documentation above).

Form 5CS - Certification of Supervisor for Limited Permit - ( 36 KB) Use this
form ONLY if you are applying/have applied for a New York State Limited Permit
as Licensed Master Social Worker online.


 * Section I: Complete this section.
 * Section II: Your supervisor must complete this section before you can submit
   it to the Office of the Professions at the appropriate address at the end of
   the form. It is your responsibility to ensure your supervisor fully completes
   Section II. Failure to complete this form will delay its review.


Form 6 - Plan for Supervised Experience - ( 28 KB) This form will not be
reviewed if submitted after the experience has been completed or if the
experience will be outside of New York State.

 * Section I: Complete this section and send the entire form and a copy of
   Appendix A to your proposed supervisor. Be sure to sign and date item 9.
 * Section II: The proposed supervisor must complete this section.

Return the completed form with the $10 fee to the Office of the Professions at
the mailing address at the end of the form

  Child Abuse Certification of Exemption Form ( 17 KB) This form is not for all
applicants. Use this form only if you are applying for an exemption to the
requirement to complete training or coursework in the identification of child
abuse and maltreatment because the nature of your practice excludes contact with
persons under the age of 18 and persons 18 or older with a handicapping
condition who reside in a residential care school or facility.

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NEW YORK STATE INSTITUTIONS/SCHOOLS

This form is for use by New York State Institutions/Schools only. Not to be used
by individuals. This form must be submitted directly by the educational
institution. The Office of Professions will not accept this form if submitted by
the applicant.

Form 20 - Certification of Graduation from a MSW Program Registered as
licensure-qualifying ( 550 KB) For use by New York State Institutions registered
by the Department as leading to social work licensure. This form may be used by
schools in lieu of individual Form 2s for students who have graduated from the
program.

Last Updated: December 1, 2021
Laws & Regulations | About OP | Contact | Forms | Q&A | IFB & RFP | Site
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UNIVERSITY OF THE STATE OF NEW YORK - NEW YORK STATE EDUCATION DEPARTMENT

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