Contested Experience/Fieldwork Form - BACB.com 2025

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The document is a Monthly Experience Verification Form used by the Behavior Analyst Certification Board (BACB) for trainees to report their supervised and independent fieldwork hours. It requires details such as trainee and supervisor names, experience type, and total hours worked. Both the supervisor and trainee must attest to the accuracy of the information provided, sign the form, and retain copies for at least seven years.

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Click ‘Get Form’ to open the Contested Experience/Fieldwork Form in our platform.
Begin by entering the Trainee Name at the top of the form. This identifies who is completing the experience.
Select the Experience Type from the provided options, ensuring you choose one that accurately reflects your situation.
Input your BACB Account ID for tracking purposes and select your Supervisor's Name and Qualification Type from the dropdown menu.
Fill in the Month/Year field to specify when this experience took place.
Record your Independent Hours and Supervised Hours in their respective fields, then calculate and enter the Total Experience Hours.
Both Supervisor and Trainee must sign and date the form at the bottom, confirming all information is accurate.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How many fieldwork experience hours are required to be eligible to become a board certified behavior analyst (BCBA)?

The total hours needed to take the BCBA exam ranges between 1,500 and 2,000 depending on the category (regular versus concentrated) of supervision you receive.

What must be submitted to the BACB to prove completed supervision hours to apply for the BCBA exam?

Onset of Fieldwork. Trainees may not start accumulating fieldwork hours until they have: Started qualifying coursework for BCBA certification (they may begin accruing hours after attending the first class meeting); and Secured a qualified supervisor (see Supervisor Qualifications above).

When to fill out final verification form BACB?

The Monthly-FVF must be signed by the last day of the calendar month following the month of supervision and we recommend that the Final-FVF be signed at the end of a specific fieldwork experience.

What are the requirements for the monthly verification form for BACB?

The Monthly Final Verification Form must be signed by the last day of the calendar month following the month of supervision. This document must be signed in accordance with the Acceptable Signatures Policy. SUPERVISOR AND TRAINEE MUST EACH RETAIN A COPY OF THIS FORM FOR AT LEAST 7 YEARS.

How to submit a BACB final verification form?

a. BACB Final Experience Verification Form: You can provide a copy of this form to your supervisor, but the supervisor must submit it directly to the Boards office. This must be a copy of the form signed and submitted to the BACB when the applicant applied to the BACB for certification.

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