TX HHS Form 3239. Initial Licensed Sex Offender Treatment Provider or Affiliate Sex Offender Treatment Provider Licensure Application

The TX HHS Form 3239, "Initial Licensed Sex Offender Treatment Provider or Affiliate Sex Offender Treatment Provider Licensure Application", is a crucial document for individuals seeking licensure as a sex offender treatment provider in Texas. This form helps solve the problem of obtaining the necessary authorization to provide sex offender treatment services.

This application requires applicants to provide essential information, including their contact details, employment history, and primary license information. Key sections include Section 1, which captures applicant contact information, and Section 2, which gathers employment data. Applicants must also attach legal documentation of any name changes and submit a copy of their primary mental health or medical license.

This form should be used by individuals seeking initial licensure as either a Licensed Sex Offender Treatment Provider (LSOTP) or an Affiliate Sex Offender Treatment Provider (ASOTP). The application is designed to ensure that applicants meet the necessary requirements for providing sex offender treatment services in Texas. By completing this form, applicants can demonstrate their eligibility and obtain the necessary authorization to provide these critical services.