Verification of Supervised Work Experience

The following submissible form can be used by Employers/Supervisors to verify periods of supervised work experience for applicants for LCSW and/or LPC licensure.  Please read the instructions carefully and use this online form only if the applicant has already submitted their application or is applying within the next three months.  Complete all required fields including attaching a published job description for the position held by the applicant and click the  button.