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Click ‘Get Form’ to open the bbs responsibility statement 37a 523 in the editor.
Begin by entering the name of the MFT Trainee/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.
Carefully review each statement under the supervisor's responsibilities. Confirm your qualifications and experience by checking the appropriate boxes and filling in any required license details.
Sign and date the form at the bottom, ensuring that all information is accurate and complete before submission.
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RESPONSIBILITY STATEMENT FOR SUPERVISORS. OF A MARRIAGE ** Applies only to supervisors NOT licensed as a Marriage and Family Therapist. 37A-523 (Rev.Read more
37A-523 (Revised 01/2020). 1 of 4. STATE OF CALIFORNIA - BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY. Gavin Newsom, Governor. Board of Behavioral Sciences.Read more
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