Applications and Forms - Mold Program

The following applications and forms are available in either Word or PDF formats.

Please see the Department of State Health Services file viewing information for help with these file formats.

License Application Forms

Mold Licensing Application Forms
Form Name Word Acrobat
Mold Analysis Laboratory License Application Word (71KB) PDF (60KB)
Mold Assessment Company Word (77KB) PDF (51KB)
Mold Assessment Consultant Word (81KB) PDF (52KB)
Mold Assessment Technician Word (78KB) PDF (79KB)
Mold Company Duplicate License Application Word (67KB) PDF (32KB)
Mold Company Name Change License Application Word (68KB) PDF (33KB)
Mold Individual Duplicate Application Word (66KB) PDF (20KB)
Mold Individual Name Change License Application Word (82KB) PDF (33KB)
Mold Remediation Company Word (72KB) PDF (59KB)
Mold Remediation Contractor Word (81KB) PDF (51KB)
Mold Remediation Worker (registration) Word (75KB) PDF (57KB)

Training Provider Accreditation and Course Approval Packet

At least one course approval application must accompany an initial application for accreditation as a Mold Training Provider.

Forms for Mold Training Provider Accreditation Packet
Form Name Word
Mold Training Provider Accreditation Application Word (63KB)
Mold Training Course Approval Application Word (51KB)
Mold Training Instructor Reference Form Word (31KB)
Mold Training Course Roster Word (45KB)

Required Training Module on Potential Health Effects of Molds (PowerPoint presentation) (164K PowerPoint)

The information in this training module, developed by the Department of State Health Services (in consultation with state associations, including at least one representing physician) is required to be used by accredited training providers as part of the training protocol for mold assessment technicians, mold assessment consultants, mold remediation contractors and mold remediation workers, as per section 295.320 of the Texas Mold Assessment and Remediation Rules.

State Licensing Exams

Before applying for licensure as a mold assessment technician, mold assessment consultant, or mold remediation contractor, an individual must first take and pass a state exam. Please click on the links below for more information.


Upcoming Testing Dates and Information on Testing Procedures
Form Name Word Acrobat
Registration Form for State Exam Word (93KB) PDF (151KB)
Examination Calendar for 2016-2017
Word (99KB) PDF (120KB)
Examination Calendar for 2017-2018Word (99KB)PDF (148KB)

Study Materials for State Exam (18K PDF)

Other Forms and Documents

Mold Remediation Notification Form (65K Word)

Certificate of Mold Damage Remediation (This link takes you to a Texas Department of Insurance webpage.)

Consumer Mold Information Sheet (107KB Word). Note:  Licensed mold assessors and remediators are required to provide a copy of this document to each client and to the property owner, if not the same person, before any mold-related activity begins. (This requirement does not apply to mold analysis laboratories or training providers).  

Complaint Form (53K Word) for reporting violations of the TMARR.

Last updated July 25, 2017