Get Documentation Of Supervised Counseling Experience

This guide provides clear instructions on completing the Documentation Of Supervised Counseling Experience. It is designed to assist you in accurately filling out this essential form as part of the licensure process for counselors in New Jersey.

Follow the steps to fill out the documentation form successfully:

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by providing your personal information in the 'Information about the applicant' section. Fill in your last name, first name, middle initial, and maiden name if applicable. Then, enter your current street address, city, state, ZIP code, telephone number (including area code), and email address.
3. Next, complete the 'Information about the supervisor' section. Include the supervisor’s last name, first name, middle initial, and maiden name if applicable. Fill out their street address, city, state, ZIP code, telephone number (including area code), and email address. Ensure that the supervisor holds a relevant professional license.
4. Respond to the questions regarding professional licensing. Indicate whether the supervisor holds a license in New Jersey and provide their license number and year licensed if applicable.
5. If the supervisor holds a license in another jurisdiction, respond similarly by specifying the type of license, state of licensure, and relevant details.
6. Fill in the graduate school information by providing the name of the school attended, the major, and the highest degree earned.
7. Indicate whether any circumstances preclude an objective assessment of the applicant. If 'Yes,' provide clarification on a separate sheet.
8. In the next section, provide the name and address of the setting where supervision occurred, along with the applicant's title, the inclusive dates of supervision, total supervised hours, and average hours of supervision provided.
9. Complete the checklist of activities performed during supervision. Indicate which activities the supervisor engaged in alongside the applicant.
10. In the supervisor’s conclusions and recommendations section, assess the applicant's readiness for licensure. Use the appropriate checkboxes for each ability and knowledge area.
11. Provide recommendations for the applicant's further professional development on a separate sheet.
12. Lastly, the supervisor must sign and date the form. Add any additional comments that may be beneficial.
13. Once all sections are completed, save your changes, and ensure to download, print, or share the form as needed.

Complete your Documentation Of Supervised Counseling Experience online today.