Gamblers Assistance Program
Provider Information
Compulsive Gambling Helpline: 1-800-522-4700 - 24-Hours / 7 Days a Week
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Applications (under previous Title 201 Regulations requirements)
for Certified Compulsive Gambling Counselors (CCGC) will be accepted until March 2010 for
review by the Certification Advisory Board in April.
Reminder: Applications for the renewal of certification for all
current CCGC’s are due by September 1, 2010.
Magellan Behavioral Health Logon & Web Site
Training Manual - www.magellanprovider.com
Certified Compulsive Gambling Counselor (CCGC) Criteria, Applications,
Instructions & Forms
For the following sections below, you may download the ZIP file with ALL the forms or
to save individual files, please right click on the item and choose Save Target As
to save to your computer's directory. These documents are in MS Office 2003 format.
CCGC Continuing Education (CEUs) Criteria & Applications:
CCGC Criteria for Approval of CEUs
CCGC Approval of CEUs Application
CCGC Sponsor/Facilitator CEU
Approval Application
ONE Zipped File Containing ALL
THREE (3) Items - CCGC CEU Criteria & Applications!
Title 201 CCGC Application Forms & Instructions:
Citizen Attestation Form
CCGC Application Booklet
CCGC Application
Documentation of Practicum
Performance
Practicum Experience Sheet
Supervisor Verification
& Evaluation Form
ONE Zipped File Containing ALL SIX (6) Items -
CCGC Application Forms & Instructions!
PCCGC & CCGC Application for Renewal:
P-CCGC Renewal Application
Instructions
P-CCGC Renewal Application
ONE Zipped File Containing Renewal Application &
Instructions!
CCGC Fee Schedule & Order Form:
CCGC Fee Schedule
P-CCGC Document Order Form
ONE Zipped File Containing CCGC Fee
Schedule & Order Form!
Documents in PDF format require the use of Adobe Acrobat Reader
which can be downloaded for free from Adobe Systems,
Inc.
Win Zip can be downloaded from Win Zip.Com
