Loading
Form preview picture

Get Lpc Quarterly Evaluation 2017-2024

Dhp.virginia.gov/counseling QUARTERLY EVALUATION FOR LPC LICENSURE Section 115-20-52-D-3 of the Virginia LPC regulations requires that the applicant s supervisor provide quarterly evaluations to the resident. This form must be signed and dated by the supervisor. This form is to be completed by the supervisor each quarter and provided to the resident to be held in their possession until they are ready to submit their licensure application. Name of Applicant Last First Middle Applicant s Email Address SUPERVISOR S EVALUATION Supervisor s Name Last First License Number License Type Business Name and Address of Residency Work Site Where Clinical Hours Were Obtained ONE LOCATION ONLY Dates of supervision From mm/dd/yy All Columns Must Be Completed To mm/dd/yy Hours per week Hours are duplicated on another supervisor s quarterly form Total hours Total hours of supervised residency face-to-face client contact hour ancillary hours How many Face-to-face Client Contact hours did the resident provide Yes No How many Individual Supervision hours did the resident receive How many Group Supervision hours did the resident receive If applicable Total number of face-to-face client contact with Couples and Families or both. COMMONWEALTH OF VIRGINIA Department of Health Professions Board of Counseling Perimeter Center 9960 Mayland Drive Suite 300 Henrico VA 23233-1463 Email coun dhp*virginia*gov Phone 804 367-4610 Fax 804 527-4435 Website www. substance abuse treatment services. These areas are outlined in Section 18 VAC 115-20-52 of the LPC Regulations. The resident must have supervised residency in the role of a professional counselor working with various populations clinical problems and theoretical approaches in the below areas. Did the applicant provide assessment and diagnosis using psychotherapy techniques while under your direct supervision while under your direct supervision under your direct supervision Do you have any concerns about the competency of the resident If yes explain on separate page. substance abuse treatment services. These areas are outlined in Section 18 VAC 115-20-52 of the LPC Regulations. The resident must have supervised residency in the role of a professional counselor working with various populations clinical problems and theoretical approaches in the below areas. The resident must have supervised residency in the role of a professional counselor working with various populations clinical problems and theoretical approaches in the below areas. Did the applicant provide assessment and diagnosis using psychotherapy techniques while under your direct supervision while under your direct supervision under your direct supervision Do you have any concerns about the competency of the resident If yes explain on separate page. substance abuse treatment services. These areas are outlined in Section 18 VAC 115-20-52 of the LPC Regulations. The resident must have supervised residency in the role of a professional counselor working with various populations clinical problems and theoretical approaches in the below areas. Did the applicant provide assessment and diagnosis using psychotherapy techniques while under your direct supervision while under your direct supervision under your direct supervision Do you have any concerns about the competency of the resident If yes explain on separate page. .

How It Works

quarterly evaluation for lpc licensure rating
4.85Satisfied
54 votes

Tips on how to fill out, edit and sign Supervision template for case managers online

How to fill out and sign Va lpc licensure online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

The preparing of lawful papers can be high-priced and time-ingesting. However, with our pre-built web templates, things get simpler. Now, working with a VA Quarterly Evaluation for LPC Licensure takes a maximum of 5 minutes. Our state-specific online blanks and simple recommendations eliminate human-prone mistakes.

Follow our easy steps to have your VA Quarterly Evaluation for LPC Licensure prepared quickly:

  1. Choose the web sample in the catalogue.
  2. Type all necessary information in the necessary fillable fields. The intuitive drag&drop interface allows you to add or move areas.
  3. Check if everything is filled in properly, without any typos or lacking blocks.
  4. Apply your e-signature to the PDF page.
  5. Simply click Done to save the adjustments.
  6. Save the data file or print your PDF version.
  7. Submit immediately to the receiver.

Take advantage of the fast search and powerful cloud editor to make a precise VA Quarterly Evaluation for LPC Licensure. Remove the routine and create papers online!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Video instructions and help with filling out and completing lpc format

Improve the method that you deal with legal papers management. Follow our video recommendations to learn how to use powerful browser-based instruments for completing your Form from your place in minutes.

Quarterly evaluation form FAQ

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to virginia quarterly lpc

  • ইএলপিসি ফরম
  • quarterly evaluation lpc
  • clinical supervision form
  • quarterly evaluation
  • lpc supervision log
  • lpc supervision forms
  • lpc supervision form
  • lpc quarterly evaluation virginia
  • lpc hours log template
  • lpc form pdf
  • lpc form
  • evaluation lpc
  • counselor evaluation form
  • competency exam
  • clinical supervision hours log template
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

  • 
                            VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

  • 
                            TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.