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Get CA 37A-675 2015-2023

E: (916) 574-7830 TTY: (800) 326-2297 www.bbs.ca.gov LICENSED PROFESSIONAL CLINICAL COUNSELOR IN-STATE EXPERIENCE VERIFICATION OPTION 1 – NEW STREAMLINED METHOD This form is to be completed by the applicant’s California supervisor and submitted by the applicant with his or her Application for Licensure and Examination. All information on this form is subject to verification. • • • • Use this “Option 1” form to report hours under the NEW streamlined method Use separate f.

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