Get Wi 2560 2017

The WI 2560 form, titled 'Documentation of Post-Graduate Clinical Experience – Supervisor’s Affidavit for Social Work License,' is essential for documenting clinical experience for licensure in social work. This guide provides detailed, step-by-step instructions to assist users in completing the form accurately and efficiently online.

Follow the steps to complete the WI 2560 form online.

1. Click ‘Get Form’ button to acquire the form and open it in the designated editor.
2. Begin by entering the applicant's full name in the designated field. Ensure correct spelling and clarity.
3. Provide the name and location of the post-graduate clinical experience facility. Accuracy is crucial for verification.
4. Enter the supervisor's name in the appropriate section, ensuring it matches official documentation.
5. Indicate the type of credential the supervisor holds, such as 'Licensed Clinical Social Worker' or similar qualifications.
6. Fill in the supervisor’s credential number accurately to ensure proper identification.
7. Document the dates the applicant was under supervision by entering the start and end dates in the specified format (mm/yy).
8. Record the total number of hours of face-to-face client contact. This should reflect the applicant's practical experience.
9. Note the number of hours of face-to-face individual or group supervision, which is necessary to quantify the supervisory experience.
10. Total the hours of clinical social work practice and enter this figure in the designated area.
11. Provide a brief description of the facility’s mission, focusing on how it serves clients and the community.
12. Describe the clients served at the facility. This should include demographics and any specific populations served.
13. Detail the applicant’s experience in providing therapy, including types of clients and treatment modalities. Use additional sheets if necessary.
14. Answer questions regarding the applicant's primary role in providing services and their capabilities concerning DSM diagnosis.
15. Complete the evaluation of the applicant by checking the appropriate boxes for competency in specified areas. Ensure all required evaluations are accurately noted.
16. Finalize the form by reviewing all entries, then save your changes, download a copy for your records, print it, or share it as required.

Prepare your WI 2560 form today and ensure a smooth licensing process!