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The document is a Fieldwork Experience Verification Form for undergraduate clinical experience in speech-language pathology and audiology. It requires applicants to provide details about their fieldwork, including the institution, location, dates, and hours earned. The form must be completed and signed by the current training program director or coordinator to verify compliance with California state requirements.

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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.