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Department of Health
John J. Dreyzehner, MD, MPH, Commissioner
Board of Social Workers
Applications
Applications
Baccalaureate Social Worker Application
(PH-4095)
Advanced Practice Social Worker Application
(PH-4094)
Affadavit for Replacement License
(PH-4055)
Criminal Background Check Instructions for Health Related Boards Applicants
Application for Licensure as a Clinical Social Worker
(PH-2082)
Master Social Worker-LMSW
(PH-2066)
Application Instructions for Special Volunteer License
(PH-3895)
Reinstatement Application
(PH-2481)
Name and Address Change Request
(PH-3619)
Affidavit of Retirement From Practice in Tennessee
(PH-3460)
Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers
(PH-3585)
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Criminal Background Check Required for New Applications
Statute Change for Release of Medical Records
> (05-16-2006)
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(03-04-2004)
Homeland Security
(02-12-2004)
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Tennessee Department of Health
425 5th Avenue North
Cordell Hull Building, 3rd Floor
Nashville, Tennessee 37243
(615) 741-3111
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tn.health@tn.gov