Get Verification Of Consultation Form - Maine

Filling out the Verification of Consultation Form is an essential step for individuals seeking licensure in social work. This guide provides clear, step-by-step instructions to help you complete the form correctly and efficiently.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to access the Verification of Consultation Form and open it in your preferred editing tool.
2. In the Licensee Data section, accurately fill in your name, license number, mailing address, city, state, zip code, work telephone, original licensure date, and place of employment during the consultation period. Ensure that all information is legible.
3. In the Consultant Data section, the consultant must complete their information, including their name, license number, mailing address, city, state, zip code, work telephone, home telephone, education/school, year graduated, and degree awarded.
4. In the Verification of Licensure section, check the appropriate boxes to confirm whether the licensee meets the specified educational and experience requirements. If applicable, provide additional details about the exam taken and how licensure was obtained.
5. Indicate if there are any pending complaints or other actions taken against the licensee. Be thorough and provide explanations where necessary.
6. In the final part of the form, the consultant must sign, print their name, title, state, phone number, and date. Ensure that the state board seal is also included if required.
7. Once the form is complete, review all entries for accuracy. Save your changes, download a copy, print the form, or share it as needed.

Complete your Verification of Consultation Form online today and ensure you meet all necessary requirements for licensure.