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Documentation of supervised counseling experience nj 2026

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  1. Click ‘Get Form’ to open the documentation of supervised counseling experience nj in the editor.
  2. Begin by filling out the applicant's information section. Clearly print the last name, first name, middle initial, and maiden name if applicable. Include the street address, city, state, ZIP code, telephone number, and email address.
  3. Next, complete the supervisor's information section using the same format as above. Ensure that all details are accurate as this will be verified.
  4. In the qualified supervisor section, check all applicable boxes indicating your qualifications. Attach any necessary verification documents.
  5. Proceed to answer questions regarding your clinical license status and provide details about your graduate school education.
  6. Fill in the setting where supervision took place along with relevant dates and total hours of supervision completed by the applicant.
  7. Complete sections regarding activities performed during supervision and maintain clarity on whether weekly notes were kept.
  8. Finally, assess the applicant’s readiness for licensure in the conclusions section and provide a signature to certify all information is true.

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lpc supervision form

N.J. Admin. Code 13:34-11.3 - Professional counselor

An applicant for licensure may take up to a maximum of six years to satisfy the supervised professional counseling experience requirement.Read more

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Documentation of Supervised Counseling Experience

1. Do you hold a clinical mental health-related professional license in the State of New Jersey? Yes No. If Yes, checkRead more

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