Forms used in the clinical supervision of counselors and therapists in training for
Washington State licensure.
Washington State Forms
for the Supervision of
Therapists and Counselors
Pre-license Reporting Forms for
Licensed Mental Health Counselors,
Licensed Independent Clinical Social Workers and
Licensed Marriage and Family
Therapists
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Forms Used by the Supervising Counselor
(and given to each counselor being supervised)
Approved Supervisor Licensed Mental Health Counselor (Form DOH 670-090,
1/2007) Please review: WAC 246-809-234
Approved Supervisor Licensed Social Worker (Form DOH 670-091--2/2007)
Please review: WAC 246-809-334
Approved Supervisor Licensed Marriage and Family Therapist
(Form DOH 670-092, 4/2007)
Please review: WAC 246-809-134
Approved Supervisor for Certified Counselor. The
form is at the end of the application packet.
Approved
Supervisor for Certified Advisor. The form is at
the end of the application packet.
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Forms Used by the Counselor to Report
Hours of Supervision to the State of Washington
"
Verification of Mental Health Counselor
Supervised Postgraduate Experience (one form for each supervisor)
Verification of Social Work Supervised Postgraduate Experience. This form is found on
the next-to-last page of the "Licensed Social Worker Application Packet"
"
Verification of Marriage and Family Therapy Supervision and Experience" form is part of the "Marriage & Family Therapist License Application Packet"
If any of these links are broken--don't be surprised. Laws governing the
credentialing of counselors are changing in 2007, and on the Washington
State's website, URL addresses frequently are changed when the content is
changed. In that case (1.)
please notify CounselingSeattle.com so we can update the links, and
(2.) follow the directions below that were kindly furnished in
May 2007, by Dawn Thompson, Program Representative, Health Professions Quality
Assurance Washington State Department of Health:
"The Approved Supervisor forms are
located with the forms and applications that pertain to the correlating
licensures....You can download these forms by going to
www.doh.wa.gov click on Topics A-Z and choose the first letter of the licensure
you need. Once you have that licensure pulled up there will be a site directory on
the left hand side. Click on 'forms and applications', then click on approved
supervisor form, down load and print...."
With the CounselingSeattle.com
counselor locator service, counselors can be located by name, geographic area, or niche specialty.
The mental health and addictions counselors listed on these pages are:
(1.) Licensed Mental Health Counselors (LMHC),
(2.) Licensed Independent Clinical Social Workers (LICSW),
(3.) Licensed Marriage and Family Therapists (LMFT), or
(4.) Registered Counselors (RC).
If you have any knowledge that any of the information about persons advertising in
CounselingSeattle.com is inaccurate or misleading,
please notify us.
To Top--Washington
State forms used in Clinical Supervision of Counselors
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