LCPAT LICENSED CLINICAL PROFESSIONAL ART THERAPIST

LCPAT

LICENSED CLINICAL PROFESSIONAL ART THERAPIST

APPLICATION INSTRUCTIONS

All forms must be legible, complete, signed, and dated (where applicable) or processing may be delayed.
Download and Complete the LCPAT Application Here
Include a payment receipt with your application.
LCPAT Application Fee: $200. PAY HERE: https://mdbnc.health.maryland.gov/pct_pay/Pay_Fee_21.aspx
Fees are non-refundable and non-transferable.

Name*

Email*

Phone*

Phone

LCPAT Application Packet Checklist

Download and Attach the Completed LCPAT Application Form

LCPAT Application Fee: $200

PAY HERE: https://mdbnc.health.maryland.gov/pct_pay/Pay_Fee_21.aspx

The following are the application requirements. All forms must be legible, complete, signed, and dated (where applicable) or processing may be delayed.

Completed Application, Signed & Notarized
LCPAT Application Payment Receipt
2 x 2 Photograph (Passport sized)
Official Transcript
Art Therapy Credential Board Exam (ATCBE)
Copy of MLA Certificate of Completion
Criminal History background Check

File Upload*

Please upload your Completed Application, Payment Receipt and Supporting Document Here.

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