Get Ma Post-masters Clinical Experience Form 2015-2026

Filling out the MA Post-Masters Clinical Experience Form online is crucial for applicants seeking licensure in mental health counseling. This guide will walk you through each component of the form to ensure a smooth and successful application process.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to obtain the form and access it in your preferred editor.
2. Begin by entering your personal information in the 'Name of Applicant' section. Ensure to print clearly or type your name.
3. Review and understand the minimum requirements outlined in the form. You will need to demonstrate 3360 total hours of relevant experience, including specific contact and supervisory hours.
4. Fill in the details of your clinical experience, including the total hours, contact hours with clients, and any group counseling hours. Be precise and accurate in your calculations.
5. In the 'Number of supervisory contact hours provided' section, document the hours you received under supervision, clearly distinguishing between individual and group hours.
6. Navigate to the supervisory section, where you will provide the name, title, license type, and contact number of your Approved Supervisor.
7. Input the name and address of the clinical facility where your experience occurred.
8. Complete the degree of supervision in the specified time frame, indicating the start and end dates.
9. Confirm whether any disciplinary action has been taken against your supervisor by checking the appropriate boxes and providing explanations as needed.
10. Once all sections are completed, review your entries for accuracy, save your changes, and choose how to download, print, or share the form.

Take the first step towards your licensure by completing the MA Post-Masters Clinical Experience Form online today.