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Larry Hogan, Governor Boyd K. Rutherford, Lt. Governor Dennis R. Schrader, Acting Secretary ___BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS 4201 Patterson Avenue, Suite 316, Baltimore, Maryland

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How to fill out clinical supervision verification

01

Gather necessary information including supervisor's name, contact information, and credentials

02

Fill out personal information including name, contact information, and license number

03

Document the number of hours completed under supervision and the dates of the supervision sessions

04

Have your supervisor sign and date the verification form

05

Submit the completed form to the appropriate organization or agency requiring the verification

Who needs clinical supervision verification?

01

Professionals seeking licensure or certification in a field that requires clinical supervision

02

Students completing internships or practicum experiences

03

Employers verifying hours of supervised experience for accreditation purposes

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What is clinical supervision verification?

Clinical supervision verification is a process where licensed healthcare professionals confirm that they have received proper supervision while practicing.

Who is required to file clinical supervision verification?

Licensed healthcare professionals who are mandated to have clinical supervision as a requirement for their practice.

How to fill out clinical supervision verification?

One can fill out clinical supervision verification by providing details about the supervising professional, dates of supervision, types of supervision received, and any additional information required by the licensing board.

What is the purpose of clinical supervision verification?

The purpose of clinical supervision verification is to ensure that healthcare professionals are receiving appropriate supervision to maintain the quality of care provided to patients.

What information must be reported on clinical supervision verification?

Information such as the name of the supervising professional, dates of supervision, types of supervision received, and any relevant details as required by the licensing board.

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