Reporting Changes in Vital Information

Reporting Changes in Vital Information A. DMH-credentialed individuals and DMH Licensed Administrator Program Participants are required to notify the Division within 14 working days of a change in legal name, address or employment. Changes are made online via the DMH prescribed system. B. Name Change 1. Each credentialed individual should ensure that his/her current wall certificate and online DMH credential profile bears his/her current legal name. An individual whose legal name has changed is expected to request a new certificate reflecting the new name. Supporting information /documentation and the name change fee must be submitted online. Once the name change is indicated in the online DMH credential profile and a new certificate is generated, the previous certificate is invalid. 2. To request a name change, the individual should submit a written/email request for a name change, along with a copy of legal documentation of the name change and payment of the name change fee. The request should indicate the new name as it should appear on the replacement certificate. Name changes reported at the time of an upgrade application do not have to be accompanied by a request, a copy of the legal documentation or the name change fee; this exemption does not apply to renewal applications. 3. Only individuals in good standing who are currently employed in the state mental health system (or in Inactive Status) may request a replacement certificate. C. Address Change An individual whose email address, mailing address and/or telephone number has changed is expected to update their online DMH credential profile with the new information. D. Employment Change 1. Upon separation of the credentialed individual from state mental health system employment, the individual’s DMH professional credential will become null and void unless he/she provides notification of reemployment in the state mental health system or requests and receives an appropriate credential status change according to the procedures established by the Division, as covered in the “Separation from State Mental Health System Employment” section below. 2. Notification of a separation from a place of employment must be submitted in writing/email to the appropriate Division by either the credentialed individual/DMH Licensed Administrator “Program Participant” OR the place of employment from which the individual is separating. 3. An individual who is either leaving state mental health system employment or changing to a new state mental health system program should follow the requirements under “Separation from State Mental Health System Employment” below.