Get Spa012 Intern Plan And Agreement Of Supervision.doc

This guide provides a clear and supportive overview for users on how to successfully fill out the SPA012 Intern Plan And Agreement Of Supervision document online. By following these simple steps, you will ensure that all necessary information is accurately captured for your internship requirements.

Follow the steps to complete the SPA012 document online.

1. Click the ‘Get Form’ button to access the SPA012 Intern Plan And Agreement Of Supervision document and open it in your online editor.
2. Fill out the intern’s name in the provided space, ensuring you use your legal name as required (Last Name, First Name, Middle Name, Suffix).
3. Enter your Intern in Speech-Language Pathology license number or your social security number (SSN) as specified in the instruction section.
4. Input the proposed supervisor’s name, following the same format of Last Name, First Name, Middle Name, and Suffix.
5. Enter the supervisor’s Texas license number to validate their qualifications.
6. Provide the supervisor's email address, confirming that you consent to receive communications electronically.
7. Select the applicable box to indicate whether you are applying for an Initial Intern license, changing your supervisor, or adding an additional supervisor.
8. If applicable, list any other current supervisors to be removed by providing their names and license numbers.
9. Complete the employer address section with the complete details where supervision will occur, including the street name, city, state, and zip code.
10. Detail the type(s) of therapy site(s) where the internship will take place, for instance, schools or clinics.
11. Carefully read the intern and supervisor's statements, then sign and date the form to validate that all information is accurate and complies with regulatory requirements.
12. Once all fields are completed and verified, proceed to save your changes, and you have the options to download, print, or share the filled form as needed.

Complete your SPA012 Intern Plan And Agreement Of Supervision document online today to ensure a smooth start to your internship.