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FIELDWORK EXPERIENCE VERIFICATION FORM FIELDWORK EXPERIENCE VERIFICATION FORM

FIELDWORK EXPERIENCE VERIFICATION FORM FIELDWORK EXPERIENCE VERIFICATION FORM 2026

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The document is a Fieldwork Experience Verification Form for undergraduate clinical experience in speech-language pathology and audiology. It outlines the necessary information to be completed by the applicant and verified by their training program director or coordinator, ensuring compliance with California state requirements.

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Click ‘Get Form’ to open the FIELDWORK EXPERIENCE VERIFICATION FORM in the editor.
Begin by entering your name in the 'APPLICANT’S NAME' field. This identifies you as the individual completing the form.
Next, input the name of your university or college in the 'UNIVERSITY OR COLLEGE' section to verify your educational institution.
Fill in the 'LOCATION WHERE EXPERIENCE WAS OBTAINED' field with the specific site where you completed your fieldwork.
Indicate the dates of your experience by filling out both 'DATES OF EXPERIENCE FROM (MO/YR)' and 'TO (MO/YR)'. Ensure accuracy for proper verification.
Record the total hours earned during your fieldwork in the 'HOURS EARNED' section, and calculate a grand total if necessary.
In the certification section, ensure that you read and understand the statement before signing. Enter your signature and date it appropriately.
Finally, have your current training program director/coordinator sign and date their section to complete the verification process.

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What is experience verification?

SUPERVISED FIELDWORK: A supervisory period is one month. In this month. You must accrue at least 20 hours, but not more than 130 hours. 4 supervision contacts with your supervisor are required in a supervisory period, and 1 observation with a client is required in this month.

How to get 2000 hours for BCBA?

For BCBA candidates, this process also involves completing a specific number of supervised fieldwork hours. BCBA candidates must complete 2,000 hours of supervised fieldwork, which can be accomplished through one of three options: supervised independent fieldwork, practicum, or intensive practicum.

How many hours do you need for BCBA fieldwork?

BCBA fieldwork consists of 1,500-2,000 hours of activities applying behavior-analytic concepts and principles to real-world situations (pathway 4 only requires 500 hours, though that pathway will be eliminated in 2027). Your fieldwork experience is supervised by a qualified supervisor (i.e., a BCBA).

Who signs the final verification form for the BACB?

This form must be signed by the last day of the calendar month following the month of supervision, and both you and your supervisor must retain copies. Once youve completed all of your fieldwork and met all of the requirements, your supervisor will sign your Final Fieldwork Verification Form.

How many hours are required for BACB monthly field work?

Fieldwork Types. There are two supervised fieldwork types: Supervised Fieldwork and Concentrated Supervised Fieldwork. Concentrated Supervised Fieldwork provides a pathway for individuals to complete their fieldwork in fewer hours and with more supervision than Supervised Fieldwork.

How long does it take to get 1500 hours for BCBA?

Total Months Required: 12.5 months (1500 hours / 120 hours per month)

Can I make 6 figures as a BCBA?

Yes. Several companies are listing salaries of 100-120k or a little more on Indeed. Im a GA BCBA and personally know of two companies hiring.

FIELDWORK EXPERIENCE VERIFICATION FORM FIELDWORK EXPERIENCE VERIFICATION FORM 2026

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