Get Supervisory Agreement Form - Texas Department Of State ...

Filling out the Supervisory Agreement Form is an essential step for obtaining your associate license with the Texas State Board of Examiners of Marriage and Family Therapists. This guide will provide clear, step-by-step instructions to assist you with completing the form online.

Follow the steps to successfully complete the Supervisory Agreement Form.

1. Click ‘Get Form’ button to access the Supervisory Agreement Form and open it in the designated editor.
2. Begin with Section I, Supervisee Information. Fill in your name, associate license number, and provide the location where you will be offering marriage and family therapy services. Include the name, address, and phone number of the agency where you will be working. Specify the type of setting you will be in by selecting one option from the provided choices, such as private practice or hospital, and indicate your work schedule as full-time or part-time.
3. Proceed to Section II, Supervisor Information. Enter the supervisor's name, business name, business address, and business phone. Confirm whether the supervisor is board-approved and provide their license number. Indicate if the supervisor is an AAMFT approved supervisor.
4. Move to Section III, Clinical Supervision Schedule. Specify the beginning date of supervision and the format of supervision (individual, group, or combination). Indicate the number of supervision sessions per month and provide a breakdown of hours for individual and group sessions.
5. Complete Section IV, Affidavit of Understanding and Signatures. The applicant must affirm the truthfulness of the provided information and sign the form. Ensure that a notary witnesses the signature and fills in their printed name, signature, and date.
6. The supervisor also needs to affirm their understanding and responsibilities. They should sign the form in the presence of a notary, who will provide their printed name, signature, and date as well.
7. Finally, review all provided information for accuracy. After ensuring everything is complete and correctly filled, you can save changes, download, print, or share the completed form as needed.

Complete your Supervisory Agreement Form online today to move forward in your licensing process.