| Reference No. |
Reference Name |
Link |
Description |
| Ref-02394 |
DH-MQA 1174 (Revised 02/13) |
http://flrules.org/Gateway/reference.asp?No=Ref-02394 |
|
| Ref-02395 |
DH-MQA 1175 (Revised 02/13) |
http://flrules.org/Gateway/reference.asp?No=Ref-02395 |
|
| Ref-03077 |
Form DH-MQA 1181, Supervised Experience Attestation Form, revised 05/13 |
http://flrules.org/Gateway/reference.asp?No=Ref-03077 |
|
| Ref-06415 |
Form DH-MQA 1175, Rev 10/15 |
http://flrules.org/Gateway/reference.asp?No=Ref-06415 |
Intern Registration Application
|
| Ref-06747 |
Form DH-MQA 1174, Application for Licensure, (rev. 02/16) |
http://flrules.org/Gateway/reference.asp?No=Ref-06747 |
Incorporated into Rule 64B4-3.001
|
| Ref-06748 |
DH-MQA 1178, Application for Limited Licensure |
http://flrules.org/Gateway/reference.asp?No=Ref-06748 |
Incorporated into Rule 64B4-3.009
|
| Ref-06749 |
DH-MQA 1177, Marriage and Family Therapy Dual Licensure Application, Rev. 02/16) |
http://flrules.org/Gateway/reference.asp?No=Ref-06749 |
Incorporated into Rule 64B4-3.010
|
| Ref-06934 |
Form DH-MQA 1175, Revised 02/16 |
http://flrules.org/Gateway/reference.asp?No=Ref-06934 |
Intern Registration Application
|
| Ref-07406 |
DH-MQA 1174, Revised 07/16 |
http://flrules.org/Gateway/reference.asp?No=Ref-07406 |
Application for Licensure
|
| Ref-07407 |
DH-MQA 1175 (Rev. 07/16 |
http://flrules.org/Gateway/reference.asp?No=Ref-07407 |
Intern Registration Application
|
| Ref-07408 |
DH-MQA 1178 (Revised 07/16) |
http://flrules.org/Gateway/reference.asp?No=Ref-07408 |
Application for Limited Licensure
|
| Ref-07409 |
DH-MQA 1177 (Revised 07/16) |
http://flrules.org/Gateway/reference.asp?No=Ref-07409 |
Marriage and Family Therapy Dual Licensure Application
|
| Ref-07835 |
DH-MQA 1181 11/16 |
http://flrules.org/Gateway/reference.asp?No=Ref-07835 |
|
| Ref-07852 |
DH-MQA 1176 1116 |
http://flrules.org/Gateway/reference.asp?No=Ref-07852 |
Incorporated into Rule 64B4-3.0075
|
| Ref-09649 |
DH-MQA 1174 (rev. 02/18) edit |
http://flrules.org/Gateway/reference.asp?No=Ref-09649 |
|
| Ref-10291 |
DH-MQA 1176 Provisional License Application |
http://flrules.org/Gateway/reference.asp?No=Ref-10291 |
|
| Ref-10292 |
DH-MQA 1177 Marriage and Family Therapy dual Licensure Application |
http://flrules.org/Gateway/reference.asp?No=Ref-10292 |
|
| Ref-10293 |
DH-MQA 1175 Intern Registration Application and Instructions |
http://flrules.org/Gateway/reference.asp?No=Ref-10293 |
|
| Ref-10294 |
DH-MQA 1178 Application for Limited Licensure and Instructions |
http://flrules.org/Gateway/reference.asp?No=Ref-10294 |
|
| Ref-10300 |
Application for Licensure - DH-MQA 1174 |
http://flrules.org/Gateway/reference.asp?No=Ref-10300 |
|
| Ref-12491 |
3.001_Applic for Licensure as a CSW MFT or Mental Health Counselor by Examination |
http://flrules.org/Gateway/reference.asp?No=Ref-12491 |
|
| Ref-12492 |
Scanned 3.009_Applic for Limited Licensure as a CSW MFT or Mental health Counselor |
http://flrules.org/Gateway/reference.asp?No=Ref-12492 |
|
| Ref-12493 |
Scanned 3.010_Application for Dual Licensure as a Marriage & Family Therapist |
http://flrules.org/Gateway/reference.asp?No=Ref-12493 |
|
| Ref-12494 |
Scanned 3.0075_Application for Provisional Licensure as a CSW Marriage Family Therapist or Mental Health Counselor |
http://flrules.org/Gateway/reference.asp?No=Ref-12494 |
|
| Ref-12733 |
Application for Registration as a Registered Intern for CSW MFT or MHC |
http://flrules.org/Gateway/reference.asp?No=Ref-12733 |
|
| Ref-12734 |
HD5044-MQA_Supervision Plan for Registered CSW Intern Form |
http://flrules.org/Gateway/reference.asp?No=Ref-12734 |
|
| Ref-12735 |
DH5045-MQA_ Grad Level Practicum Internship or Field Experience Verification Form MFT |
http://flrules.org/Gateway/reference.asp?No=Ref-12735 |
|
| Ref-12736 |
DH5046-MQA_ Graduate Level Practicum Internship or Field Experience Verification Form CSW |
http://flrules.org/Gateway/reference.asp?No=Ref-12736 |
|
| Ref-12737 |
DH5047-MQA_ Graduate Level Practicum Internship or Field Experience Verification Form MHC |
http://flrules.org/Gateway/reference.asp?No=Ref-12737 |
|
| Ref-13496 |
DH5065-MQA, Registered Intern Exception Request Form |
http://flrules.org/Gateway/reference.asp?No=Ref-13496 |
|
| Ref-13497 |
DH-MQA 1181 Verification of Clinical Experience |
http://flrules.org/Gateway/reference.asp?No=Ref-13497 |
|
| Ref-14256 |
DH-MQA 5049 Qualified Supervisor Statement Instructions and Form |
http://flrules.org/Gateway/reference.asp?No=Ref-14256 |
|
| Ref-15228 |
DH-MQA 5048 Application for Licensure as a CSW_MFT or MHC by Endorsement |
http://flrules.org/Gateway/reference.asp?No=Ref-15228 |
|
| Ref-15366 |
DH-MQA 5065 Registered Intern Exception Request Form |
http://flrules.org/Gateway/reference.asp?No=Ref-15366 |
|
| Ref-16613 |
DH-MQA 5078 "Supervision Log" |
http://flrules.org/Gateway/reference.asp?No=Ref-16613 |
DH-MQA 5078 "Supervision Log"
|
| Ref-16696 |
DH-MQA 5048 Application for Licensure as a Clinical Social Work, Marriage and Family Therapy or Mental Health Counselor by Endorsement |
http://flrules.org/Gateway/reference.asp?No=Ref-16696 |
DH-MQA 5048 Application for Licensure as a Clinical Social Work, Marriage and Family Thera...
|
| Ref-16698 |
DH-MQA 1174, Application for Licensure as a Clinical Social Worker, Marriage & Family Therapist or Mental Health Counselor by Examination |
http://flrules.org/Gateway/reference.asp?No=Ref-16698 |
DH-MQA 1174, Application for Licensure as a Clinical Social Worker, Marriage & Family Ther...
|
| Ref-16705 |
DH5045-MQA Graduate-Level Practicum, Internship, or Field Experience Verification Form Marriage and Family Therapy |
http://flrules.org/Gateway/reference.asp?No=Ref-16705 |
DH5045-MQA Graduate-Level Practicum, Internship, or Field Experience Verification Form Mar...
|
| Ref-17167 |
DH5045-MQA, Graduate-Level Practicum, Internship, or Field Experience Verification Form – Marriage and Family Therapy |
http://flrules.org/Gateway/reference.asp?No=Ref-17167 |
|
| Ref-17168 |
DH-MQA 1175, Application for Registration as a Registered Intern for Clinical Social Work, Marriage & Family Therapy or Mental Health Counseling |
http://flrules.org/Gateway/reference.asp?No=Ref-17168 |
|
| Ref-17183 |
DH-MQA-5101 (eff. 08/24) Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) |
http://flrules.org/Gateway/reference.asp?No=Ref-17183 |
|
| Ref-18100 |
DH-MQA 5049, Qualified Supervisor Statement Instructions and Form (Revised 3/2025) |
http://flrules.org/Gateway/reference.asp?No=Ref-18100 |
|
| Ref-18547 |
DH-MQA 1176 Application for Provisional Licensure as a Clinical Social Worker Marriage and Family Therapist or Mental Health Counselor 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18547 |
|
| Ref-18548 |
DH-MQA 1177 Application for Dual Licensure as a Marriage and Family Therapist 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18548 |
|
| Ref-18549 |
DH-MQA 1181 Verification of Clinical Experience 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18549 |
|
| Ref-18551 |
DH-MQA-5101 Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18551 |
|
| Ref-18555 |
DH-MQA 1174 Application for Licensure as a Clinical Social Worker, Marriage and Family Therapist or Mental Health Counselor by Examination 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18555 |
|
| Ref-18556 |
DH-MQA 1178 Application for Limited Licensure as a Clinical Social Worker, Marriage and Family Therapist or Mental Health Counselor 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18556 |
|
| Ref-18557 |
DH-MQA 1175 Application for Registration as a Registered Intern for Clinical Social Work, Marriage and Family Therapy or Mental Health Counseling 5/2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18557 |
|
| Ref-18678 |
DH-MQA-5101 Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) 8.2025 |
http://flrules.org/Gateway/reference.asp?No=Ref-18678 |
|