Form GEN4B Download Printable PDF or Fill Online Registration of
Lcsw Form 4B. Web before you accept a position practicing clinical social work. Web complete and submit this form, making sure to sign and date item 10;
Form GEN4B Download Printable PDF or Fill Online Registration of
Assigned number (from form 4): Web before you accept a position practicing clinical social work. Request your supervisor to submit verification of your supervised hours in diagnosis and psychotherapy on form 4b. This form must be submitted directly by the supervisor. Read the attached appendix a and complete all of section ii. Web find form 2 here: Nysed office of the professions. Web licensed clinical social worker. This form must be submitted directly by your supervisor. Licensed clinical social worker form 4, page 2 of 2, revised 8/17.
Applicants must hast supervised experience approved in order to meet licensing eligibility. Be sure to complete a separate form 4b for each supervised experience listed on your applicant experience record (form 4). Web find form 2 here: Be sure to sign and date item 8. Web licensed clinical social worker form 4b certification of experience for licensed clinical social worker instructions for completing section ii: Web before you accept a position practicing clinical social work. Request your supervisor to submit verification of your supervised hours in diagnosis and psychotherapy on form 4b. You must also complete a separate form 4b for each supervised experience you list on the applicant experience record (form 4). Web complete and submit this form, making sure to sign and date item 10; Assigned number (from form 4): Web licensed clinical social worker form 4b certification of experience for licensed clinical social worker applicant instructions.
