Get Lpc Supervision Master Checklist (example)

Filling out the LPC Supervision Master Checklist online is a crucial step for both supervisors and LPC interns to ensure compliance with licensing requirements. This guide provides clear instructions on completing each section of the checklist accurately and efficiently.

Follow the steps to complete your LPC Supervision Master Checklist online.

1. Press the ‘Get Form’ button to access the LPC Supervision Master Checklist and open it in the editor.
2. Enter the name of the supervisor in the designated field at the top of the form.
3. Provide the contact information for the supervisor, including phone number and email address.
4. Enter the name of the LPC intern in the corresponding section of the form.
5. Fill in the contact information for the LPC intern, ensuring all details are current.
6. Confirm that the Supervisory Agreement Form is signed and indicate this by checking the box next to it.
7. Include a copy of the current LPC-S license and attach it as specified.
8. Attach a copy of the Site/Supervisor Approval Letter from the LPC Board Office.
9. Provide online confirmation of the Supervisor and LPC Intern status when prompted.
10. Record the confirmation of supervisory site(s) by the supervisor in the space provided.
11. If applicable, check off copies of site change forms sent to the Board along with return receipts.
12. Document supervision logs initialed at each session in the appropriate section.
13. Include notes of content for each session, clearly outlined on logs and in the file.
14. Attach copies of any Supervisor-approved LPC-Intern advertising as required.
15. Document notes of discussions on LPC rules/statutes in the logs.
16. Note any remediation plans or progress for the intern within the file.
17. If there were any address changes for either the supervisor or intern, include copies with return receipts.
18. Attach receipts for any supervision payments or financial agreements held in the file.
19. Ensure copies of the intern file, logs, and notes sent to the board after completing 3000 hours are included.
20. Attach a copy of the licensing approval wall certificate or deficiency letter as applicable.
21. Finally, have both the supervisor and LPC intern sign and date the form to affirm that the checklist and materials accurately reflect their professional experience.

Complete your LPC Supervision Master Checklist online to ensure you meet all necessary requirements.