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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 3/29/24)

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

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 (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

Non-Academic Notification PDF

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 August 2021

Provo MHRT I Form DOC    Provo MHRT I Form PDF

Simple Steps to MHRT I Certification, March 2024

Not available in Word    Simple Steps to MHRT I Certification PDF

MHSS Training Notification Form (Updated March 18, 2024)

Training Notification Form Word    Training Notification Form PDF

MHSS Training Validation Form (Updated March 18, 2024)

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 August 2023

Word CSP Request Form PDF CSP Request Form

MHRT/CSP 2011 Procedural Guidelines

Word CSP Guidelines       PDF CSP Guidelines

Workshop Allocation Form–for DHHS-OBH Employees only

Workshop form Word    Workshop form PDF