Bbs responsibility statement 2026

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The document outlines the responsibilities and requirements for supervisors of Professional Clinical Counselor (PCC) interns in California, as mandated by Title 16 of the California Code of Regulations. It details the qualifications, training, and ethical obligations that licensed mental health professionals must adhere to while supervising interns, including maintaining a valid license, providing adequate supervision, and ensuring compliance with legal standards. The supervisor must sign a statement confirming their qualifications and understanding of these responsibilities before commencing supervision.

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Click ‘Get Form’ to open the bbs responsibility statement in the editor.
Begin by entering the name of the PCC Intern in the designated fields for Last and First names.
Next, input your name as the Qualified Supervisor, including your Middle name if applicable.
Provide your Daytime Telephone Number to ensure easy communication.
Review each statement carefully. For each item listed under 'As the supervisor', check the box confirming your compliance and fill in any required details such as license numbers and issue dates.
Complete all sections regarding your qualifications, experience, and understanding of supervision laws. Ensure that you provide accurate information as this is a legal document.
Finally, sign and date the form at the bottom. Make sure to provide a mailing address for correspondence.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (105 Votes)
2018	4.3 Satisfied (107 Votes)
2010	4.2 Satisfied (51 Votes)

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bbs responsibility statement 2022

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