DVOMB Provider Applications

  • Please read and understand the Qualifications Section 9.0 of  the Standards before submitting an application.
  • Please note that all application fees are non-refundable. For questions, please contact Carolina Thomasson at Carolina.thomasson@state.co.us
  • To be listed as a DVOMB approved provider, please fill out the appropriate application below. Applications 2 through 4 are used to request approval primarily based upon a well-documented community need that cannot be met by existing providers. Please call the Standards Coordinator at (303) 239-4536 to discuss how our rural programs may apply to you.
  • You must submit a completed Assessment of Applicant's Evaluations by DV Clinical Supervisor (PDF) for each evaluation you send in. 

Applications (All links are PDF files)

  1. Application for Entry Level (see Section 9.01 of the Standards)
  2. Application for Provisional Level (see Section 9.07 of the Standards)
  3. Intent to Apply for Provisional via the Judicial Rural Initiative
  4. Application for Provisional Level via the Judicial Rural Initiative
  5. Application for Full Operating Level (see Section 9.02 of the Standards)
  6. Application for DV Clinical Supervisor Level * (see Section 9.03 of the Standards) *For individuals who have been approved and practicing at the Full Operating Level for a minimum of one year.
  7. Specific Offender Population Application (see Section 10.0 of the Standards) This is an additional application to be used by a DVOMB-Approved Provider or an individual applying to be a provider to request approval to treat a specific offender population. Currently we offer appoval for  treating females or same sex partners.
  8. Move Up Application (NEW) - Use this application if you are an Approved Entry Level Provider and wish to apply for Full Operating Level.
  9. Reapplication for Replacement
  10. Provider Application for FOL DVOMB and Applicant Competency Assessment - Are you already approved by the Sex Offender Management Board as a Full Operating Level Adult Treatment Provider or Evaluator? If yes, please call the Standards Coordinator at (303) 239-4536 for more information about applying to the DVOMB's Approved Provider List.

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