TX HHS Form 3248. Chemical Dependency Counselor Intern Registration Application

Form 3248 is the official application used in Texas to register as a Chemical Dependency Counselor Intern (CI). This document is required for individuals who are beginning the process of becoming a Licensed Chemical Dependency Counselor (LCDC) or who need to extend their existing intern registration. The form is issued and administered by the Texas Health and Human Services Commission (HHSC) and is governed by Texas Administrative Code (26 TAC), Chapter 562.

Purpose of the Chemical Dependency Counselor Intern Registration

The primary purpose of Form 3248 is to formally register an individual as a Chemical Dependency Counselor Intern. Intern registration allows applicants to legally gain supervised experience while completing the education, examination, and training requirements necessary for full LCDC licensure in Texas.

This form is mandatory for anyone who plans to work toward LCDC licensure through the intern pathway. It documents identity, education, compliance with ethical standards, and agreement to state licensing rules.

Who Must File This Form

Form 3248 must be completed by:

• Individuals applying for an initial Chemical Dependency Counselor Intern registration
• Current interns requesting an extension or subsequent registration as allowed under 26 TAC §562.14

This form should not be used by individuals who are already fully licensed as LCDCs or who are applying through a different licensure route.

Explanation of Each Section of the Form

Section 1 – Personal Information

This section collects identifying and contact information, including full legal name, Social Security number, date of birth, sex, residential address, phone number, and email. Accurate information is essential, as discrepancies may delay background checks or application processing.

Section 2 – Education Information

Applicants must disclose their highest level of education, degree details, and school information. HHSC uses this section to determine whether the applicant meets education requirements or qualifies for exemptions under 26 TAC §562.6.

Section 3 – Initial Intern Registration Fee

This section confirms payment of the nonrefundable application and background investigation fee. For initial registration, the required fee is $65, payable by check or money order to the Texas Health and Human Services Commission.

Section 4 – Statement of Understanding

This is a critical compliance section where applicants initial multiple statements acknowledging education requirements, examination requirements, supervised experience rules, ethical obligations, and consequences of providing false information. Failure to properly complete this section may result in application rejection.

Section 5 – Notarized Signature and Attestation

The applicant must sign the form in the presence of a notary public. By doing so, the applicant attests to having read and agreed to all applicable licensure laws and rules under 26 TAC Chapter 562.

Section 6 – Checklist for Initial CI Registration

This checklist ensures that all required documents for initial registration are included, such as notarized application, photo, official transcripts, and fees. Missing items are a common cause of processing delays.

Section 7 – Checklist for Subsequent CI Registration

Applicants seeking an extension of intern registration must complete this section. While fewer documents are required than for initial registration, notarization, photo submission, and fees remain mandatory.

Section 8 – GovDelivery Updates

This optional section allows applicants to subscribe to official HHSC updates regarding changes to Chemical Dependency Counselor licensing rules.

Section 9 – Required Photo

A recent full-face, wallet-size photo must be attached or taped to the form. This photo is used for identification and licensure records.

Common Mistakes Applicants Make

• Submitting photocopies instead of official sealed transcripts
• Forgetting to notarize the application
• Including incomplete education details
• Sending incorrect payment amounts or payment methods
• Failing to submit required documents within one year, causing the application to be voided

Documents Commonly Required

• Notarized Form 3248
• Recent full-face wallet-size photograph
• Official college transcripts (or confirmation they are sent directly)
• Application and background investigation fee
• Additional practicum documentation if no approved degree is held

Legal and Regulatory Background

Form 3248 is regulated under Texas Administrative Code, Title 26, Chapter 562. These rules establish the legal framework for counselor intern registration, education requirements, ethical standards, background checks, and pathways to full LCDC licensure. Submission of this form is legally required to engage in supervised chemical dependency counseling work in Texas.

Practical Tips for Completing the Form

• Type directly into the form to ensure legibility
• Double-check education dates and degree titles
• Confirm notarization before mailing
• Use trackable mail for sending transcripts and fees
• Keep copies of everything submitted

Real-Life Scenarios Where This Form Is Required

• An individual who recently completed a counseling degree and needs supervised hours to qualify for LCDC licensure
• A counselor intern whose registration is nearing expiration and requires an extension
• A career changer entering the substance abuse counseling field under Texas licensure rules

Frequently Asked Questions

Is Form 3248 required for all LCDC applicants?

No. It is required only for those pursuing licensure through the intern registration pathway.

Can I submit Form 3248 electronically?

No. The completed form, supporting documents, and fees must be mailed to HHSC.

Are application fees refundable?

No. All application and background investigation fees are nonrefundable.

What happens if my application is incomplete?

Incomplete applications may be delayed or voided if required documents are not submitted within one year.

Do I need a degree before applying?

You must either hold an approved degree or meet specific coursework and practicum requirements outlined in 26 TAC §562.6.

Micro-FAQ

• Purpose: Register as a Chemical Dependency Counselor Intern in Texas.
• Who files: Individuals seeking LCDC licensure through intern registration.
• Deadline: No fixed deadline, but applications expire after one year if incomplete.
• Attachments: Photo, transcripts, notarized form, and fees.
• Submitted to: Texas Health and Human Services Commission.

Related Forms and Resources

• Texas LCDC Licensure Application
• Supervisor Designation Forms
• Chemical Dependency Counselor Examination Applications
• Other Texas Health Professions Licensing Forms

Form Details

• Form Name: Chemical Dependency Counselor Intern Registration Application
• Form Number: 3248
• Service Code: 529201037
• Issuing Authority: Texas Health and Human Services Commission (HHSC)
• Region: Texas
• Revision Date: July 2025