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Get Ca 37a-675 2015-2026
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How to fill out the CA 37A-675 online
The CA 37A-675 form, also known as the In-State Experience Verification form, is essential for applicants seeking licensure as a Licensed Professional Clinical Counselor in California. This guide will provide clear instructions to help you complete the form accurately and efficiently online.
Follow the steps to successfully complete the form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your name in the 'Applicant Name' section, ensuring to include your last, first, and middle names as well as your intern number.
- Provide the supervisor's information by filling out the supervisor’s last name, their address, license type, license number, state, and business phone.
- Indicate the dates of experience being claimed by entering the 'From' and 'To' dates in mm/dd/yyyy format.
- Respond to the supervisor certification questions regarding their qualifications and supervision experience, including board certification and compliance with California law.
- Fill in the applicant's employer information, including the employer's name, address, and business phone.
- Answer the series of questions about the experience setting, confirming if it was a lawful mental health counseling environment.
- Document the number of weeks and logged hours of supervised experience, detailing both direct counseling and non-clinical hours.
- Note the hours of face-to-face supervision you received during your experience and include the individual and group supervision hours.
- Review the entire form for accuracy and completeness before signing, ensuring that your supervisor initials any changes.
- Once satisfied with the form, save your changes, and proceed to download, print, or share the completed CA 37A-675 as required.
Complete your documents online today for a smooth application process.
To apply for a California resale certificate, complete the CA 37A-675 form, ensuring it includes your business information and seller's permit number. Submit it to the vendor from whom you are purchasing goods for resale. For simplified processes, consider using resources from uslegalforms that guide you in filling out the necessary paperwork.
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