Get Wa Doh 670-064 2023-2025

The WA DOH 670-064 form is essential for verifying the supervised experience of individuals seeking certification as Substance Use Disorder Professionals. This guide provides clear, step-by-step instructions on how to complete the form online to ensure a smooth application process.

Follow the steps to complete the WA DOH 670-064 form online.

1. Press the ‘Get Form’ button to access the WA DOH 670-064 document. This will open the form in an online editor for you to fill out.
2. Begin by entering the applicant's information. Include their last name, first name, middle name, birth date (in mm/dd/yyyy format), address, city, state, zip code, phone number, and business phone number.
3. Proceed to the section for the direct supervisor. Fill in the supervisor's last name, first name, middle name, credential number, street address, city, phone number, state, and zip code.
4. Record the supervised experience details, including the start date (mm/dd/yyyy) and end date (mm/dd/yyyy). List the competencies gained during this experience.
5. Indicate whether the first fifty hours of face-to-face client contact were under direct observation of the supervisor or another Substance Use Disorder Professional.
6. The supervisor should sign and date the form to attest that the information provided is accurate. Include the total hours of supervised experience as needed.
7. Once all sections are completed, review the document to ensure accuracy. You can then save changes, download, or print the completed form for submission.

Complete your documents online today to ensure a timely process for your certification.