LMFT Experience Verification In-State Option 2 LMFT Experience Verification In-State Option 2 - bbs ca 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the 'APPLICANT NAME' section, ensuring you include your last, first, and middle names along with your intern number.
3. In the 'SUPERVISOR INFORMATION' section, provide your supervisor's details including their name, address, license type, and license number. Ensure accuracy as this information is subject to verification.
4. Indicate whether the experience was pre-degree or post-degree by marking the appropriate box.
5. Fill out the 'EXPERIENCE INFORMATION' section with dates of experience claimed and total weeks of supervised experience. Log hours for individual psychotherapy, couples therapy, group therapy, telehealth counseling, and any workshops attended.
6. Review all entries for completeness and correctness before signing. Make sure your supervisor initials any changes made.

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