Loading
Get Ia Supervised Clinical Experience: Approval And Attestation 2009
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the IA Supervised Clinical Experience: Approval and Attestation online
Filling out the IA Supervised Clinical Experience: Approval and Attestation online is a crucial step for both supervisors and applicants in the licensure process. This guide provides detailed instructions to help users navigate the form efficiently and accurately.
Follow the steps to complete your form with ease.
- Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
- Complete Part 1, which requires the supervisor to provide personal information, including their name, mailing address, phone number, and email address. Ensure all fields are accurately filled out.
- Fill in the supervisor’s education and license information, including the title, degree/major, university, and details about the license/certification. This section confirms the qualifications of the supervisor.
- Document the supervisor’s most recent clinical experience, providing details on employer, duration, and setting type. This helps establish the supervisor’s expertise.
- Outline the planned supervised experience with start and end dates, along with the employment setting details. List the name and contact information of the agencies involved.
- Describe the professional duties that will be performed under supervision. Use additional pages if necessary to provide complete information.
- Review the supervisor’s attestation section, where the supervisor will certify the accuracy of the provided information. Ensure that the supervisor includes their signature and date.
- Once Part 1 is complete, proceed to Part 2, where completion information about the supervised experience must be recorded.
- Fill in the duration of supervised experience, total hours for group and individual supervision, and the number of direct client contact hours. Be precise in documenting these details.
- Both the supervisor and the applicant should sign their respective attestation sections certifying the completion of the supervised experience. Include dates for clarity.
- Submit the completed form as directed, ensuring to attach a copy to the electronic licensure file and retain a copy for personal records.
Complete your documentation online to ensure a smooth application process!
Get form
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
To qualify as a Licensed Mental Health Counselor (LMHC) in Iowa, you must possess a master's degree in a relevant field and complete supervised clinical experience. Additionally, you will need to fulfill any required training or coursework that aligns with IA Supervised Clinical Experience: Approval and Attestation. A passing score on the licensing exam is also essential to practice professionally.
Get This Form Now!
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.