Get Ca 77s-60 2022-2026

This guide provides clear instructions on how to fill out the CA 77S-60 form, the responsibility statement for supervisors of a speech-language pathology assistant. Whether you are a supervisor or a speech-language pathology assistant, this step-by-step guide will help ensure that you complete the form accurately and efficiently.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill out Part A, which includes the speech-language pathology assistant's information. Ensure you provide the full legal name, license number, street address, city, state, zip code, and email address.
3. Complete Part B by entering the supervisor's information. This must include the full legal name, license number or credential document number, street address, city, state, zip code, and email address.
4. In Part C, indicate the date supervision began and answer whether the assistant has more than one supervisor. If applicable, specify if you will serve as the lead supervisor.
5. Proceed to sign the statement regarding the duties and responsibilities of both the assistant and the supervisor. Each person must provide their printed name and the date.
6. Ensure that all sections are filled out accurately. Review the entire form to confirm that no fields are left incomplete.
7. Once completed, save the document. You may also choose to download, print it, or share the form as required.

Complete your CA 77S-60 form online today for efficient processing.