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 9/29/23)
MHRT/Community Application Form (Appendix D)
Application (Appendix D) Word
Application (Appendix D) PDF
MHRT/Community 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 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 August 2021
Provo MHRT I Form DOC
Provo MHRT I Form PDF
Simple Steps to MHRT I Certification, January 2022
Not available in Word Simple Steps to MHRT I Certification PDF
MHSS Training Notification Form (Updated April 16, 2020)
Training Notification Form Word
Training Notification Form PDF
MHSS Training Validation Form (Updated April 16, 2020)
Training Validation Form Word
Training Validation Form PDF
MHSS Student Information Form (Updated April 16, 2020)Student Information Form Word
Student Information Form PDF
MHSS Curriculum Modification Request Form MHSS Curriculum Modification Form Word
MHSS Curriculum Modification Form PDF
MHSS Training Policies & Procedures Manual
MHSS Policy & Procedure Manual Word
MHSS Policy & Procedure PDF
MHSS Student Evaluation Form
MHSS Student Evaluation Form Word
MHSS Student Evaluation Form 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