NC BLCMHC Verification of Supervised Professional Practice 2020-2026 free printable template

Verification of Supervised Professional Practice To be completed by LC MHC Applicants and Supervisors Indicate to which Applicant this supervised professional practice form applies: Name: VERIFICATION

How to fill out NC BLCMHC Verification of Supervised Professional Practice

How to fill out NC BLCMHC Verification of Supervised Professional Practice

1. Obtain the NC BLCMHC Verification of Supervised Professional Practice form from the official website or your supervisor.
2. Fill in your personal details, including your name, address, and contact information.
3. Provide details of your supervised professional practice, including the name of the supervisor and the facility.
4. Indicate the start and end dates of your supervised practice.
5. Describe the clinical activities you have engaged in during your practice.
6. Have your supervisor sign the form to verify the information provided.
7. Submit the completed form to the NC BLCMHC as part of your application process.

Who needs NC BLCMHC Verification of Supervised Professional Practice?

1. Individuals applying for licensure as a mental health counselor in North Carolina.
2. Those who have completed a supervised professional practice requirement as part of their graduate program in counseling.
3. Candidates seeking to meet the eligibility criteria for the National Certified Counselor (NCC) exam.

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What is NC BLCMHC Verification of Supervised Professional Practice?

NC BLCMHC Verification of Supervised Professional Practice is a formal process used to confirm that an individual has completed the required supervised practice hours in the field of mental health counseling as stipulated by the North Carolina Board of Licensed Clinical Mental Health Counselors.

Who is required to file NC BLCMHC Verification of Supervised Professional Practice?

Individuals seeking licensure as a Licensed Clinical Mental Health Counselor in North Carolina must file the NC BLCMHC Verification of Supervised Professional Practice to demonstrate that they have met the necessary supervision requirements.

How to fill out NC BLCMHC Verification of Supervised Professional Practice?

To fill out the NC BLCMHC Verification of Supervised Professional Practice, an applicant must complete the designated form by providing personal information, details of supervised practice, dates of supervision, and signatures from both the applicant and the supervisor confirming the accuracy of the information.

What is the purpose of NC BLCMHC Verification of Supervised Professional Practice?

The purpose of the NC BLCMHC Verification of Supervised Professional Practice is to verify that an applicant has undergone the required amount of supervised practice in counseling, ensuring they have the necessary practical experience to provide effective mental health services.

What information must be reported on NC BLCMHC Verification of Supervised Professional Practice?

The information that must be reported includes the applicant's personal details, the number of supervised hours completed, the setting in which the supervision occurred, the qualifications of the supervisor, and confirmation of the accuracy of the reported data.