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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.us
KATIE
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How to fill out verification of clinical supervision
How to fill out verification of clinical supervision
01
Gather all necessary documentation and forms required for verification of clinical supervision.
02
Fill out personal information accurately including name, date of supervision, supervisor's name and credentials.
03
Document the number of hours of supervision received and the dates of supervision sessions.
04
Include a brief description of the activities or cases discussed during supervision.
05
Sign and date the verification form and ensure that your supervisor also signs and dates the form.
06
Submit the completed verification form to the appropriate governing body or organization for approval.
Who needs verification of clinical supervision?
01
Individuals in professions such as counseling, social work, psychology or other mental health fields who are required to document and verify their clinical supervision hours.
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What is verification of clinical supervision?
Verification of clinical supervision is a process to confirm that a clinician has met the required supervision hours and competencies.
Who is required to file verification of clinical supervision?
Clinicians who are seeking licensure or certification in a specific field are required to file verification of clinical supervision.
How to fill out verification of clinical supervision?
Verification of clinical supervision can be filled out by documenting the hours and competencies gained during supervised practice, and having a licensed supervisor sign off on the form.
What is the purpose of verification of clinical supervision?
The purpose of verification of clinical supervision is to ensure that clinicians have received adequate training and supervision before becoming licensed professionals.
What information must be reported on verification of clinical supervision?
The information that must be reported on verification of clinical supervision includes the number of supervision hours completed, the competencies gained, and the signature of a licensed supervisor.
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