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  • Ca Bbs 37a-522 2018

Get Ca Bbs 37a-522 2018-2026

STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Governor Edmund G. Brown Jr. Board of Behavioral Sciences 1625 North Market Blvd. Suite S200 Sacramento CA 95834 Telephone 916 574-7830 TTY 800 326-2297 www. bbs. ca.gov RESPONSIBILITY STATEMENT FOR SUPERVISORS OF AN ASSOCIATE CLINICAL SOCIAL WORKER Title 16 California Code of Regulations 16 CCR Section 1870 requires any qualified licensed mental health professional who assumes responsibili.

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How to fill out the CA BBS 37A-522 online

The CA BBS 37A-522 form is essential for licensed mental health professionals supervising those working towards licensure as a Licensed Clinical Social Worker in California. This guide provides step-by-step instructions on how to complete this form online, ensuring clarity and thoroughness for all users.

Follow the steps to successfully complete the CA BBS 37A-522 form.

  1. Press the ‘Get Form’ button to access the CA BBS 37A-522 form in your online document editor.
  2. Enter the associate's name and ASW number in the designated fields at the top of the form.
  3. Fill in the supervisor's name as it appears on their license.
  4. Confirm your licensure status by checking the appropriate box indicating you have been licensed in California for at least two years prior to commencement of supervision. Provide your license type and number.
  5. Acknowledge that you will maintain your license in good standing and notify the associate of any disciplinary actions as required.
  6. Indicate that you have two years of clinical practice or direct supervision experience within the last five years preceding this supervision.
  7. Verify that you have completed the minimum of fifteen contact hours in supervision training, including specific content as outlined.
  8. Confirm competency in supervision based on your experience, training, and education.
  9. Acknowledge understanding of the laws and regulations regarding clinical supervision and licensure.
  10. Commit to developing a supervisory plan for the associate and ensure compliance with practice regulations.
  11. Review the patient/client records and evaluate the associate's performance throughout the supervision duration.
  12. Provide the completed, signed original of this form to the associate before supervision begins.
  13. Complete an annual assessment of the associate's strengths and limitations as required.
  14. Sign and date the form, confirming your compliance with all stated requirements.
  15. After completing the form, save your changes, and you may choose to download, print, or share the completed CA BBS 37A-522 form.

Complete your CA BBS 37A-522 form online today to facilitate supervision and licensure!

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