Get Wi 2464 2022-2025

The WI 2464 form is essential for applicants seeking to document their clinical experience under supervision in the fields of marriage and family therapy, professional counseling, and social work. This guide will lead you through the process of filling out the form online in a clear and supportive manner.

Follow the steps to complete the WI 2464 online effectively.

1. Click the ‘Get Form’ button to access the necessary document for your submission. This will open the form in your preferred online editor.
2. Enter the application number in the designated field at the top of the form. This number is crucial for identifying your application.
3. Provide the name of the applicant in the specified area, ensuring it is printed clearly.
4. Fill in the applicant's training license number, ensuring accuracy as per documentation.
5. Include the name of the supervisor responsible for overseeing the applicant’s clinical experience.
6. Indicate the supervisor’s licensure profession and license number, ensuring they are valid and up-to-date.
7. Record the dates during which the applicant was under supervision, providing both start and end dates.
8. Specify the total number of hours the applicant was supervised, as well as the number of hours of face-to-face client contact.
9. Identify the facility where the applicant gained their client contact experience, including the full address.
10. Briefly describe the applicant’s clinical responsibilities in their position, focusing on the relevant duties.
11. Sign the document where indicated, and if digital signing is not possible, print the form for a signature.
12. Ensure all sections are completed before saving your changes, then download, print, or share the completed form as necessary.

Start completing your WI 2464 online today!