24 Miss. Code. R. § 6-5-4 - Special Requests

During the renewal process, some certificants/ licensees recognize that they need to make additional special requests.

A. Name Change: A certificant/licensee who wants to report a legal name change at the time of renewal is expected to follow the directions found in Chapter 6, Section 4, C., (4), p. 38 and submit all necessary documentation/ fees along with the Renewal Application packet by the June 30th renewal deadline. Please note that this request includes a total required payment of $85.00 which includes both the Renewal Fee ($60.00) and the Certificate Replacement Fee ($25.00).

B. Inactive Status Request: A certificant/ licensee who is not employed in the state mental health system as described in Chapter 3, Section 1, C., p. 7 at the time of renewal may want to include a request for Inactive status along with the Renewal Application packet. The guidelines and instructions for requesting Inactive status are found in Chapter 3, Section 7, C., (2), pp. 16-17. Such an individual is expected to make this request AND renew by the June 30th deadline submitting all required renewal form(s)/materials/fees(s) except the Renewal Verification of Employment Form.

Additional assistance may be obtained by contacting the Division.

C. Retired Status Request: A certificant/licensee who has retired should follow instructions found in Chapter 3, Section 7, C., (4), p. 17. A certificant/licensee who wishes to request Retired status is expected to do so by the June 30th renewal deadline.

D. Relinquished Status Request: A certificant/licensee who determines that he/ she no longer wants or needs to hold and maintain professional credentialing may submit a written request for Relinquished status. Instructions for making this request are found in Chapter 3, Section 7, C., (5), p. 17. A certificant/licensee who wishes to request Relinquished status is expected to do so by the June 30th renewal deadline.

Notes

24 Miss. Code. R. § 6-5-4