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CDP Verification of Supervision Experience & Statement of Qualifications. This form is used to verify a supervisor 's experience and qualifications as a Chemical Dependency Professional in Washington State. - doh wa 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the applicant's information, including their name, birth date, address, and phone numbers. Ensure all details are accurate for verification purposes.
- Next, provide the direct supervisor's information. This includes their name, credential number, and contact details. It's crucial that this section is completed thoroughly to validate the supervisor's qualifications.
- In the 'Supervised Experience' section, input the dates of supervision and total hours worked. Be sure to specify competencies gained during this experience as required by WAC regulations.
- The supervisor must attest to the accuracy of the information by signing and dating the form. This step is essential for compliance with state requirements.
- Finally, review all entries for completeness before submitting the form directly to the provided address.
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Related links
Oct 28, 2020 Chemical Dependency Professionals of Washington State is the states NAADAC affiliate and serves as an additional professional resourceRead more
The national certification must be active and in good standing, with a verification form completed by the approved supervisor. See Approved SupervisorRead more