Get Mi Lara/bpl-mft1000hrs 2019-2026

The MI LARA/BPL-MFT1000HRS form is essential for individuals seeking full licensure in marriage and family therapy. This guide provides a clear and supportive overview of how to successfully fill out this online document step-by-step.

Follow the steps to complete the MI LARA/BPL-MFT1000HRS online

1. Click ‘Get Form’ button to obtain the form and access it in the online editor.
2. In the first section, enter the applicant’s first name, last name, and middle name as they appear on official documents.
3. Provide the applicant’s date of birth using the format MM/DD/YYYY.
4. Fill in the applicant’s place of employment, including the organization name, street address, city, state, and ZIP code.
5. Input the supervisor’s first name, last name, and their registration/license/credential number.
6. Indicate the level of certification or licensure held by the supervisor at the time of providing supervision.
7. Specify the issuing jurisdiction or organization of the supervisor's credential.
8. Enter the date the supervisor’s credential was issued.
9. If applicable, state whether the Board approved a special supervisory situation and list the date if yes.
10. In the certification and signature section, the supervisor must confirm that the applicant obtained marriage and family therapy experience under their supervision. Fill in details regarding direct client contact supervision as outlined.
11. Indicate the total hours of direct client contact supervision provided, along with the experience start and end dates.
12. Finally, the supervisor must sign and date the form to declare the accuracy of the information provided.
13. After completing the form, you can save changes, download, print, or share the document as needed.

Complete your MI LARA/BPL-MFT1000HRS online today to ensure your full licensure.