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Forms

Forms for Applicants

 The following items are required for LCSW, CSWA, LMSW, and RBSW applications.

LCSW

- CSWA

- LMSW

- RBSW

 

- LICENSE VERIFICATION

OREGON STATUTES & ADMINISTRATIVE RULES EXAM (Together with Oregon's Rules and Statutes)

(also commonly reffered to as the Oregon Jurisprudence Exam)

NON-SOCIAL WORK CREDENTIAL VERIFICATION

Finger Printing instructions are found on the home page, under APPLYING FOR A LICENSE.

 
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Request Forms from the Board Office

The following forms are available for download at this web site. Printed or electronic copies of these forms may also be requested from the State Board of Licensed Social Workers office:
State Board of Licensed Social Workers
3218 Pringle Road SE, Suite 240
Salem, OR 97302-6310
Phone: (503) 378-5735
Fax: (888) 252-1046
Toll Free Number: (866)-355-7050

E-mail: oregon.blsw@state.or.us 
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Forms for Licensees

CSWA 6 MONTH EVALUATION REPORT

CSWA PLAN CHANGE PACKET - The Plan of Supervision is an agreement for a Minnimum of six months, before it may be changed. If you have an extenuating circumstance, please notify board staff.

**Please note that CSWA Candidate forms are for use by CSWA Candidates only.

*CSWA CANDIDATE PLAN 

 CHANGE OF ADDRESS FORM

CUSTODIAN OF RECORD DESIGNATION

 

ANY CHANGES TO A PLAN OF SUPERVISION OR CANDIDATE PLAN IS RECOMMENDED TO BE SUBMITTED 4-6 WEEKS IN ADVANCE TO AVOID A BREAK IN HOURS.

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Renewal Forms & Information

 
The board office has transitioned to online renewals. If you would prefer a paper renewal you may download and print the form below.

If you are requesting a status change, you MUST complete a paper renewal and sign on the line for the requested status. Pay the requested status fee, and submit Continued Education requirement for such status.

REQUEST FOR INACTIVE STATUS
May not use the title of LCSW or volunteer or practice clinical social work in the State of Oregon while license is Inactive. Biennial renewal is still applicable.
 
REQUEST FOR SEMI-RETIRED STATUS
Still engaged in meeting the Continuing Education requirements as defined in OAR 877-025-0000.  Practicing or volunteer social work service in the State of Oregon beyond the 500 hours as required by OAR 877-020-0060(2)(c). 
To qualify for Semi-Retired status, applicants must have been under the authority of a licensing agency
(licensed/registered/certified) for 20 years and no disciplinary action within the last 15 years.
This is an active license.
 

Completed Renewal Forms must be post marked by the last day of your birth month (renewal date), or you will be assessed the appropriate late fee.  Late fees are: $200 for Active LCSWs, and $50 for CSWAs, LMSWs, RBSWs, LCSWs on Inactive or Reduced Requirements (Semi-Retired) status. 

Renewal forms received after the expiration date (30 days after the birth month renewal date) will not be processed, and the license will be "lapsed".  Once lapsed, LCSWs, CSWAs, LMSWs, and RBSWs will be allowed to renew with the appropriate fees, up to one year past the renewal date. An afidavit stating, they had not been practicing without a license is also required.  After the 12 months maximum lapsed time, a new application will be required inorder to obtain a new license.
 
It is the responsibility of each licensee or certificate holder to notify the Board of any changes to addresses or employer information. Failure to receive a renewal notice from the Board shall not constitute an excuse for failure to pay the renewal fee or to renew one's license/certificate. 

 

 
 
IF YOU OWE CONTINUING EDUCATION:
Please submit our CE Attestation Form along with your renewal form.
If you are audited, you will need this form as well.
 
Fee Reminder:
RBSW (Active): 110.00
RBSW(Inactive): 40.00
 
LMSW(Active): 220.00
LMSW(Inactive): 80.00
 
CSWA(Active): 66.00
 
LCSW (Active): 286.00
LCSW (Inactive): 106.00
LCSW(SemiRetired): 143.00 
 
If you are unsure of your hours, your CE requirement, or have any questions about the renewal process, please fee free to email the board at oregon.blsw@state.or.us.
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Consumer Protection Forms

 
To make a complaint against a Licensed Clinical Social Worker, Clinical Social Worker Associate, Licensed Master's Social Worker or Registered Baccalaureate Social Worker licensed in the state of Oregon, please download a CONSUMER PROTECTION COMPLAINT PACKET  and submit it to our Board Office. nd submit it to our Board Office.

AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION Form

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