21 NCAC 64 .0106 PLAN FOR AND REPORT OF SUPERVISED PROFESSIONAL EXPERIENCE
Applicants must submit Form B, Plan for Supervised Experience, before being approved for a temporary license, and within 20 days of the completion of the supervised experience they must submit Form C, Report of Supervised Experience. Form B requires the name and address of applicant, the name and address of the applicant's supervisor, the number of hours per month of various clinical activities, and the number of hours per month of various types of supervision. Form C requires name and address of the applicant, the name and address of the applicant's supervisor, the beginning and ending dates of the supervision period, the frequency and types of supervision actually provided, and an evaluation of the applicant in the area for which a license is sought.
History Note: Authority G.S. 90‑298;
Eff. November 1, 1989;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. October 4, 2016.