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Bbs responsibility statement 2026

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  1. Click ‘Get Form’ to open the bbs responsibility statement in the editor.
  2. Begin by entering the name of the associate in the designated fields for Last, First, and Middle names.
  3. Input the Associate Professional Clinical Counselor (APCC) number and the name of the qualified supervisor.
  4. Fill in the supervisor's daytime telephone number to ensure easy communication.
  5. As a supervisor, confirm your licensing status by selecting your license type and entering your license number and issue date.
  6. Review each statement carefully, checking the boxes that apply to your qualifications and experience as outlined in sections A through F.
  7. Sign and date the form at the bottom, ensuring all information is accurate before submission.

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