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Mental Health Counselor Form 5CS - New York State ...

www.op.nysed.gov

Mental Health Counselor Form 5CS Certification of Supervisor for Limited Permit Use this form ONLY if you are applying/have applied for a New York State Limited Permit as a Mental Health Counselor online. Applicant Instructions. 1. Complete Section I. Give your supervisor a copy of Appendix A and have them complete Section II.

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