Certification forms

The certifications forms are now available online. A list of the forms, and the corresponding certifications are shown below. The current forms take the place of the former facesheets, and recommendation forms that were submitted by the Chapter, in the past.

The following forms are in Microsoft Word. Please follow the instructions on the form to complete and submit them. Detailed instructions for the certification process are found in the CPSP Certification Manual. If you need Word, you can get it for free HERE.

Certification Form
(Click on the name of the form to download it)		  Certificate(s)
Consultation Report for Clinicians Clinical Chaplain/Pastoral Counselor;
Associate Clinical Chaplain/Pastoral Counselor
Consultation Report for Diplomate in Pastoral Psychotherapy Diplomate in Pastoral Psychotherapy
Consultation Report for Diplomate in Pastoral Supervision Diplomate in Pastoral Supervision
Training Supervisor's Report of Recommendation
for CPSP Diplomate Supervisor Candidate		 Diplomate in Pastoral Supervision 
Consultation Report for Pastoral PsychotherapistPastoral Psychotherapist

Consultation Report for SIT and TS Program

Training Supervisor Candidate Registry Form

Supervisor-in-Training or Training Supervisor

Register training supervisors 
Consultation Report for Hospice and Palliative Care* Clinical Fellow in Hospice and Palliative Care;
Associate Clinical Fellow in Hospice and Palliative Care
Consultation Report for Clinically Trained Minister* Clinically Trained Minister
Certification by Reciprocity All Clinician and Diplomate certifications;
applies to members currently certified
by a cognate organization.
*Contact Krista Argiropolis, Administrative Coordinator, for forms.



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