Get Evaluation Of Supervised Experience - Lpc Draft .doc - Ok 2006-2025

This guide provides a comprehensive overview of the process for filling out the Evaluation of Supervised Experience document for Licensed Professional Counselors. It aims to help users understand each section of the form to ensure accurate completion.

Follow the steps to complete the evaluation form effectively.

1. Press the ‘Get Form’ button to access the Evaluation of Supervised Experience document and open it for editing.
2. In the candidate’s name field, enter your full name as it appears on your identification. Be sure to print clearly.
3. In the approved supervisor's name field, input the full name of your supervisor, also printed clearly.
4. Fill in the date the supervision agreement was approved by the department. Use the format MM/DD/YYYY for clarity.
5. Record the work week beginning date, using the same date format. This indicates the start of the reported supervision period.
6. Document the date or dates you met with your supervisor in the appropriate section, ensuring each meeting date is listed.
7. Enter the total number of face-to-face supervision hours gathered during the period for both group and individual sessions under the respective columns.
8. Input the total number of direct client contact hours you provided, being careful to ensure accuracy.
9. Calculate the total number of supervised experience hours overall, and fill in this total in the designated field.
10. Sign and date the candidate’s signature field to validate your report. Likewise, ensure your supervisor signs and dates their respective field.
11. After completing all fields, you can save changes to your document, download it, print a copy, or share it as necessary.

Complete your evaluation form online today to ensure compliance and keep your records up to date.