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LPC EVALUATION OF SUPERVISED EXPERIENCE Name of Supervised: Board Approved Supervisor: Is the Board Approved LPC Supervisor also acting as the Board Approved Onsite Supervisor? Yes: No: Name of Candidate's

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How to fill out lpc supervisor agreement form

1. Obtain a copy of the LPC supervisor agreement form from your state licensing board or the organization you are seeking supervision from.
2. Read the form carefully to understand the requirements and obligations for both the supervisor and supervisee.
3. Fill out the personal information section, including your name, contact details, license number, and supervisor's name.
4. Provide details about the supervision arrangement, such as the location, frequency, and duration of supervision sessions.
5. Specify the method of supervision, whether it will be face-to-face, phone, video conferencing, or a combination of these.
6. Agree upon the fees and payment terms for supervision services, if applicable.
7. Review and sign the agreement, ensuring that you understand and are willing to comply with the terms stated.
8. Make a copy of the signed agreement for your records and submit the original to the appropriate authority.

Who needs lpc supervisor agreement form?

1. Licensed Professional Counselors (LPCs) who intend to provide supervision to aspiring counselors or interns typically need the LPC supervisor agreement form. It is also required by individuals seeking supervision as part of their counseling licensure process. The form establishes a formal agreement between the supervisor and supervisee, outlining the terms and responsibilities of the supervision relationship.

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What is lpc supervisor agreement form?

The LPC Supervisor Agreement Form is a document that outlines the agreement between a Licensed Professional Counselor (LPC) and their supervisor regarding supervision requirements and expectations.

Who is required to file lpc supervisor agreement form?

Any Licensed Professional Counselor (LPC) who is receiving supervision from a supervisor is required to file the LPC Supervisor Agreement Form.

How to fill out lpc supervisor agreement form?

The LPC Supervisor Agreement Form can be filled out by providing information such as names of the supervisor and supervisee, supervision hours, supervision methods, and signatures of both parties.

What is the purpose of lpc supervisor agreement form?

The purpose of the LPC Supervisor Agreement Form is to establish clear expectations and guidelines for supervision between a Licensed Professional Counselor (LPC) and their supervisor.

What information must be reported on lpc supervisor agreement form?

The LPC Supervisor Agreement Form must include details such as names of supervisor and supervisee, supervision hours, supervision methods, and signatures of both parties.