Get Supplementary Evaluation For Every Three Months

Filling out the SUPPLEMENTARY EVALUATION FOR EVERY THREE MONTHS can be a straightforward process when approached step-by-step. This guide will assist you in completing the form accurately and effectively to ensure a smooth evaluation process.

Follow the steps to complete your online form efficiently.

1. Press the ‘Get Form’ button to access the evaluation form and open it in your preferred editor.
2. Begin by entering your name as the applicant in the designated field. Make sure to print clearly or type to ensure legibility.
3. Select your professional designation by checking the appropriate box for either 'Speech-Language Pathologist' or 'Audiologist.'
4. Proceed to section I titled 'EVALUATION - FIRST ONE-THIRD.' Here, assess your performance in the listed areas: Assessment/Diagnosis, Habilitation/Rehabilitation, Client/Patient Counseling, Record Keeping, and Other. Indicate your achievements for each area by marking the appropriate field.
5. Continue to section II and repeat the process for the 'EVALUATION - SECOND ONE-THIRD' section, marking your achievements in the same areas as before.
6. Next, fill out section III titled 'EVALUATION - THIRD ONE-THIRD' by once again evaluating your performance and marking the appropriate fields.
7. Sign and date the section for the evaluator after completing all evaluations. Ensure that the evaluator's signature and date are accurate before moving on.
8. Complete section IV by detailing your type of evaluation activities and noting the number of hours spent per week on each activity. Calculate and enter the total hours in the specified field.
9. In section V, provide information on the evaluator's on-site observations and monitoring activities, indicating the number of hours spent on each listed activity.
10. Conclude with section VI, where both the evaluator and the provisional licensee must certify the accuracy of the information by signing and dating the form.
11. Once you have filled out the entire form, review it for completeness and accuracy. You can then save your changes, download a copy, print it for your records, or share it as needed.

Complete your SUPPLEMENTARY EVALUATION FOR EVERY THREE MONTHS online today for a more efficient experience.