Get Ne Application For Certification Of Supervision Of An Audiology Or Speech-language Pathology 2014-2025

Filling out the NE Application For Certification Of Supervision Of An Audiology Or Speech-Language Pathology online is an important step for professionals seeking to supervise assistants in the field. This guide will provide you with a detailed, step-by-step approach to ensure a smooth application process.

Follow the steps to successfully complete your application online.

1. Press the ‘Get Form’ button to access the application form and open it for editing.
2. Provide your name in Section A along with your current address, including street, city, state, and zip code.
3. Enter your Nebraska license number and specify the area in which the assistant will be working by checking the appropriate box for audiology or speech-language pathology.
4. In Section B, input the name of the audiology or speech-language pathology assistant you will be supervising.
5. Indicate whether you are supervising other assistants by checking 'Yes' or 'No', and if 'Yes', list their names and the number of hours you supervise them each week.
6. Complete Section C by providing the practice site’s information, including the facility name and its street address, city, state, and zip code.
7. In Section D, select the tasks that the audiology or speech-language pathology assistant will perform by checking the appropriate boxes.
8. Describe how you will use an alternate supervisor when necessary and outline the method of supervision that the alternate supervisor will employ.
9. In Section E, attest to the supervision requirements and responsibilities, ensuring to sign and date the attestation.
10. Once all sections are completed, review the form for accuracy. You can then save your changes, download, print, or share the completed application.

Complete your application online today to facilitate the supervision certification process.