Get Form 4b Lcsw

Filling out Form 4b Lcsw online is an essential step in the certification process for licensed clinical social workers. This guide will walk you through each section of the form to ensure your submission is complete and accurate.

Follow the steps to successfully complete Form 4b Lcsw online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section I, enter your social security number if applicable and your date of birth. If you do not have a U.S. social security number, leave this section blank.
3. Provide your name exactly as it appears on your application. Make sure to fill in the telephone and email address fields clearly, noting if they are for home or business.
4. Complete your mailing address with correct city, state, and ZIP code details. Ensure that this information is accurate and up to date.
5. In the fields for license and degree information, enter your New York State LMSW license number, the date it was issued, the date you received your M.S.W. degree, and your registration end date.
6. Specify your clinical supervisor's name, their qualifications, the setting where the supervised experience took place, and the setting's address.
7. Confirm the accuracy of your information by signing and dating item 8 of the form. Ensure that you understand that any misleading information may impact your application.
8. Send the completed form and Appendix A to your supervisor for their part of the certification. They will fill out Section II and send the entire form directly to the Office of the Professions.
9. Make sure to save your changes, download a copy of the completed form for your records, and print or share it as necessary.

Complete your Form 4b Lcsw online today for a smooth application process.