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CLINICAL SUPERVISION VERIFICATION
INFORMATION & INSTRUCTIONS
Submit Supervision Plans and Supervision Verification forms using
ONLINE SERVICES or DOWNLOADABLE FORMS at the Boards website.
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How to fill out clinical supervision verification
How to fill out clinical supervision verification:
01
Start by gathering all necessary documentation and information. This may include your personal information, the name and contact information of your supervisor, and any relevant time frames or dates.
02
Begin filling out the form by providing your personal information, such as your full name, contact information, and any identification numbers that may be required.
03
Indicate the purpose of the clinical supervision verification form, specifying that you are seeking verification for supervision hours completed.
04
Clearly state the name and contact information of your supervisor, ensuring that all information provided is accurate and up-to-date.
05
Include the duration of the clinical supervision, specifying the start and end dates or the number of hours completed.
06
Describe the type of clinical setting or program in which the supervision took place. This can include the name of the institution, organization, or facility.
07
Provide any additional details or information that may be required, such as the specific tasks or responsibilities performed during the supervision period.
08
Sign and date the form to confirm that all information provided is true and accurate.
09
Submit the completed clinical supervision verification form to the appropriate authority or organization.
Who needs clinical supervision verification:
01
Individuals seeking licensure or certification in a healthcare or mental health profession often require clinical supervision verification.
02
Students or trainees undergoing clinical supervision as part of their educational or training programs may also need to obtain verification.
03
Healthcare facilities or organizations that provide clinical supervision to staff members may require verification to ensure compliance with regulations and quality control measures.
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What is clinical supervision verification?
Clinical supervision verification is a process where a supervisor confirms that a supervisee has completed required clinical hours.
Who is required to file clinical supervision verification?
Individuals who are completing clinical hours for licensure are required to file clinical supervision verification.
How to fill out clinical supervision verification?
Clinical supervision verification can be filled out by the supervisee and the supervisor, confirming the number of clinical hours completed.
What is the purpose of clinical supervision verification?
The purpose of clinical supervision verification is to ensure that individuals seeking licensure have completed the necessary clinical hours under supervision.
What information must be reported on clinical supervision verification?
Information such as the number of hours completed, dates of supervision, and signatures of both the supervisee and supervisor must be reported on clinical supervision verification.
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