Documents and Forms

The following forms are available in MS Word and Adobe PDF (version 5.0) formats.  If you do not have Adobe Acrobat, you may download a copy from the Adobe Website. Click on the title below for the certification/program you want to expand that section.

MHRT/Community Guidelines

MHRT/C Guidelines (As of 2/18/20)

MHRT/Community Application Form (Appendix D)

Application (Appendix D) Word Application (Appendix D) PDF

MHRT/Community Knowledge Competencies

MHRT-C Knowledge Competencies

MHRT/C Renewal Form

Renewal Form Word Renewal Form PDF

MHRT/Community Credit for Work Experience (Waiver) Forms (Appendix G)

Domain 2: Community Integration and Inclusion (only available to individuals with a qualifying degree)

Domain 2 PDF

Domain 4: Trauma and Resiliency

Domain 4 PDF

Domain 5: Policy Knowledge

Domain 5 PDF

          Domain 6: Mind-Body Connection

Domain6 PDF

Domain 7: Cultural Competency

Domain 7 PDF

Domain 8: Vocational Support

Domain 8 PDF

If you are completing 2008 requirements and need a Credit for Work Experience Form for one of the 2008 courses, please contact us

MHRT Work Experience Verification Form

Required for those who have not completed a relevant program or degree.

 Work Experience Verification Word   Work Experience Verification PDF


Provisional Mental Health Support Specialist (MHSS) Handbook 2006

Provo Handbook Word    Provo Handbook PDF

Provisional MHRT I Certificate from the back of the Provisional Mental Health Support Specialist (MHSS) 
UPDATED June 2014

Provo MHRT I Cert Word    Provo MHRT I Cert PDF

Simple Steps to MHRT I Certification, April 2018

Not available in Word    Simple Steps to MHRT I Certification PDF

Workshop Allocation Form–for DHHS-SAMHS Employees only

Workshop form Word    Workshop form PDF

MHRT/CSP Application Form (Can only be submitted by agency)
UPDATED July 2017

Word CSP Request Form PDF CSP Request Form

MHRT/CSP 2011 Procedural Guidelines

Word CSP Guidelines       PDF CSP Guidelines