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Click ‘Get Form’ to open it in the editor.
Begin with Part I, where you will enter your personal information. Fill in your name, last four digits of your Social Security number, address, email address, and daytime telephone number.
Proceed to Part II, which must be completed by a program official. Ensure that the official fills in the classroom training details including start and end dates.
The program official should check off the required areas of classroom training that you have satisfactorily completed.
Next, the program official will need to provide clinical training details. They should also check off the clinical requirements you have met.
Finally, ensure that the program official signs and dates the form, providing their contact information and institution details.

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Versions	Form popularity	Fillable & printable
2022	4.2 Satisfied (22 Votes)
2017	4.1 Satisfied (46 Votes)
2015	4.2 Satisfied (60 Votes)

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Can I sign my form route 2 electronically?

According to eSignature regulations, forms approved digitally have the same validity as those approved with pen and paper. You can electronically sign almost any business and private paperwork. Four types of paperwork still demand handwritten signatures only - wills and testamentary trusts, court orders and other court papers, state statutes governing divorce, adoption, or other family law, and notice of cancellation of utility services. If you adhere to the rules and utilize a reliable and compliant software solution, like DocHub, you can eSign your form route 2 without printing it.

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