Licensing Application

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Licensing Application

Here you will find out how to apply for a state license to provide all other services—with the exception of children's residential services—for individuals who have or who are at risk of mental illness, serious emotional disturbance, intellectual disabilities, substance use disorders, or brain injury. This includes applicants wanting to become licensed under the Rules and Regulations for the licensing of providers of mental health, mental retardation, and substance abuse services, the Individual and Family Developmental Disabilities Support Waiver and Brain Injury Residential Services.

(Please click here if you are applying for a license to provide children’s residential services.)

REQUIREMENTS FOR A LICENSE

To be licensed by DBHDS to provide services (with the exception of children's residential services) the application must:

  • Submit and receive preliminary approval of the Initial Provider Application [and required attachments].
  • Submit, receive approval of, and demonstrate knowledge of required licensing policies, procedures and forms.
  • Submit and receive approval of required Human Rights Policies and Procedures.
  • Set up an account and request criminal history and central registry background investigations for identified staff as required by Virginia Code §37.2-405 and submit Child Protective Services reference checks.
  • Have an on-site review of the physical plant, to include interviews with applicants over the content of their service description and policies and procedures, as well as compliance with other regulations, and copies of forms and sample client and personnel records.

INITIAL PROVIDER LICENSING APPLICATION

The Initial Provider Licensing Application packet is for applicants interested in becoming providers of all other services—with the exception of children's residential services.  In the packet, the new provider applicant will find necessary forms and information needed to successfully apply for a license and manage your program. Obtain your initial application packet in one of three ways: 

  • Download for free the Initial Provider Application packet documents; or
  • Send a completed order form and $35.00 for just the application packet (see tab below on Fees); or
  • Order the New Applicant Training DVD for $75.00–the application packet is included (see tab below on Training DVD). New Applicant Training is strongly encouraged prior to submitting your application.  The training will provide you with information that will help you to successfully apply for a license and manage your program. 

Initial Provider Application Packet (At no cost to you, download the entire application packet on individual forms as needed) Licensing Process Overview

Licensing Tools:


 


Renewal Application - Please use this form to renew a license.

Service Modification Application - Please use this form when you are already licensed and want to want to modify the license or add a service or location. Please submit the completed form 30-60 days prior to implementation of the modification.

 

Due to budget reductions, the Office of Licensing is no longer able to offer live training for applicants interested in becoming providers of all other services – with the exception of children's residential services. We highly recommend our new training DVD that will provide you with the information you need to successfully apply for a license and manage your program.

The Training DVD includes a recording of the actual training, plus comments by the offices of Human Rights and Intellectual Disabilities.  Also included is the entire application packet containing regulatory information, application materials and management tools.  Once purchased, you will own the DVD, be able to refer back to it repeatedly and share it with your staff at a time convenient for you.

To order the DVD (the entire application packet will be included with your DVD) please send your payment of $75.00 along with the completed order form.

(If you only want the application packet, you may send $35.00 and the completed order form, or you may download the application packet materials for free using the links above.)

 

The Department can only accept payments in the form of a check or money order.  The following licensing services are available to providers and provider-applicants:

  • There is a $35.00 fee if you opt to receive the Initial Provider Application packet through the mail; or choose to download the packet for free using the links above.
  • The cost of the Initial Provider Training DVD — plus the entire application packet — is $75.00
 
Please mail the completed order form with a CHECK or MONEY ORDER to the following address.  If you have any questions, you may phone (804) 786-9302.

DBHDS, Office of Licensing
Attention: Office of Licensing
P.O. Box 1797
Richmond, VA 23218-1797