Bbs.ca.govpdflawchanges2022Gavin Newsom, Governor Business, Consumer Services and ... 2026

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The document is a weekly log template for Associate Professional Clinical Counselors in California, designed to track experience hours across different work settings. It includes sections for personal and supervisor information, types of counseling provided, and categories of experience such as direct counseling and non-clinical activities. The log is not to be submitted unless requested by the Board of Behavioral Sciences.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated fields for 'Last', 'First', and 'Middle' names.
Fill in the 'Supervisor Name' and 'Name of Work Setting' along with its address.
Indicate your status when logging hours by selecting the appropriate checkbox.
If known, enter your BBS File Number in the provided space.
Record your total hours per week by filling out sections A (Direct Counseling) and B (Non-Clinical Experience).
Ensure you have your supervisor sign where indicated before finalizing the document.

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Versions	Form popularity	Fillable & printable
2022	4.9 Satisfied (23 Votes)
2021	4.3 Satisfied (65 Votes)
2019	4.3 Satisfied (32 Votes)
2018	4.2 Satisfied (65 Votes)
2016	4.7 Satisfied (27 Votes)

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