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
MHRTC Guidelines (As of 6/29/26)
MHRT/Community Application Form (Appendix D)
Application (Appendix D) Word Application (Appendix D) PDF
- Use this form for your initial MHRT/C application under Pathways A, B, or C.
- It is also required whenever submitting additional paperwork to meet any missing Domain requirements.
MHRT/Community Knowledge Competencies
MHRT/C Renewal Form
Renewal Form Word Renewal Form PDF
Note: Do not use this form to submit Domain completion paperwork for your second Pathway B or C MHRT/C certificate. For that, use Appendix D.
- Use this form if you are renewing your Full MHRT/C certification.
- Once you’ve earned the two-year Full MHRT/C, you must complete continuing education every two years for renewal. Submit this form along with your continuing education certificates.
MHRT/Community Credit for Work Experience (Waiver) Forms (Appendix G)
Domain 2: Community Integration and Inclusion
Domain 4: Trauma and Resiliency
Domain 5: Policy Knowledge
Domain 6: Mind-Body Connection
Domain 7: Cultural Competency
Domain 8: Vocational Support
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 (Pathway C)
Required of Pathway C applicants who do not have college education (4 year unrelated degree or at least 30 related credits or a 2 year related degree).
Work Experience Verification Word Work Experience Verification PDF
MHRT Non-Academic Training Notification Form
Provisional Mental Health Rehabilitation Technician I (Provo-MHRT I) Handbook 2006
Provo-MHRT I Handbook Word Provo-MHRT I Handbook PDF
Provisional MHRT I Certificate from the back of the Provisional Mental Health Support Specialist (MHSS)
UPDATED June 1, 2025
Provo MHRT I Form DOC Provo MHRT I Form PDF
Simple Steps to MHRT I Certification, June 1, 2025
Not available in Word Simple Steps to MHRT I Certification PDF
MHSS Training Notification Form (Updated June 1, 2025)
Training Notification Form Word Training Notification Form PDF
MHSS Training Validation Form (Updated June 1, 2025)
Training Validation Form Word Training Validation Form PDF
MHSS Student Information Form (Updated March 18, 2024)Student Information Form Word Student Information Form PDF
MHSS Training Policies & Procedures Manual (Updated March 18, 2024)
MHSS Policy & Procedure Manual Word MHSS Policy & Procedure PDF
MHRT/CSP Application Form (Can only be submitted by agency)
UPDATED June 2025 (CFL contact info)
Word CSP Request Form PDF CSP Request Form
MHRT/CSP 2011 Procedural Guidelines
Word CSP Guidelines PDF CSP Guidelines