supervised work experience documentation form lcdc 2008 Preview on Page 1

Supervised work experience documentation form lcdc 2008-2026

The document is a Supervised Work Experience Documentation Form for Counselor Interns (CIs) that must be completed for each job title held by the intern. It requires personal information, job details, and supervision confirmation from a Qualified Credentialed Counselor (QCC). The form must be submitted to the Texas Department of State Health Services along with the intern's job description. It outlines responsibilities for reporting hours worked and conditions under which hours may be denied. Additionally, it emphasizes the importance of accurate information and timely submission.

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out supervised work experience documentation form lcdc 2008 with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering your Counselor Intern Information. Fill in your name, social security number, and date of birth. Ensure accuracy as this information is crucial for processing.
Next, provide details about your CTI Site Information. Include the headquarters name, site name, telephone number, and complete address.
In the Training Information section, input the dates of service and job title during that timeframe. Remember to attach a copy of your job description for verification.
Complete the Qualified Credentialed Counselor Information by indicating if direct supervision was provided. If not, include the supervisor's name and license number.
Finally, sign and date the form at the bottom to affirm that all information is true and accurate before submitting it to the Texas Department of State Health Services.

Start using our platform today for free to streamline your document editing and submission process!

See more supervised work experience documentation form lcdc 2008 versions

We've got more versions of the supervised work experience documentation form lcdc 2008 form. Select the right supervised work experience documentation form lcdc 2008 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (41 Votes)
2011	4 Satisfied (31 Votes)
2008	4.1 Satisfied (63 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Can I sign my supervised work experience documentation form lcdc 2008 on a mobile?

Sure, you’ll find numerous apps for this on the web. Nonetheless, if you need to eSign your supervised work experience documentation form lcdc 2008 without installing extra software, DocHub is the optimum choice you can make. This powerful editor works on mobile devices just like on desktops. Open our editor in any internet browser, register or sign in to your account, and start processing your paperwork.

How to complete supervised work experience documentation form lcdc 2008 on the internet free of charge in 2024?

Using a swift editing platform like DocHub, you do not need anything but a web browser and internet connection to edit your supervised work experience documentation form lcdc 2008 on the internet quickly. Add your file or get the relevant form in DocHub’s catalog, open our editor with a single click, and finish it electronically. To edit your forms at any time, sign up a free account with DocHub.