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STATE OF ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS 1740 WEST ADAMS STREET, SUITE 3600 PHOENIX, AZ 85007 PHONE: 602.542.1882 FAX: 602.364.0890 Board Website: www.azbbhe.us Email Address: information@azbbhe.usKATIE
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How to fill out verification of clinical supervision

01
Obtain the verification of clinical supervision form from the appropriate licensing board or organization.
02
Fill out your personal information including your name, contact information, and license number.
03
Provide details about your supervision experience such as the names of your supervisors, the dates of supervision, and the number of supervision hours completed.
04
Include any additional information or documentation required by the licensing board or organization.
05
Submit the completed form along with any supporting documentation to the licensing board or organization for review and approval.

Who needs verification of clinical supervision?

01
Individuals who are applying for or renewing their professional license in a field that requires clinical supervision.
02
Professionals seeking to demonstrate that they have met the supervision requirements set forth by their licensing board or organization.
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Verification of clinical supervision is a process where a licensed professional certifies that they have provided supervision and oversight to a trainee or intern in a clinical setting.
Licensed professionals who provide supervision to trainees or interns in a clinical setting are required to file verification of clinical supervision.
Verification of clinical supervision forms can be filled out by providing details of the supervising professional, trainee or intern, dates of supervision, and a description of the clinical setting and activities.
The purpose of verification of clinical supervision is to ensure that trainees or interns are receiving appropriate supervision and guidance in their clinical practice.
The verification of clinical supervision form must include details such as names of the supervising professional and trainee/intern, dates of supervision, description of clinical activities, and signatures of both parties.
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