Information for Supervisors

Clinical Supervisor Requirements

To provide clinical supervision, an individual must:

Individuals who would like to be added or updated on the Clinical Supervision Registry in the Online Registry, or who would like to have their education reviewed shall submit the Clinical Supervision Application in the BOARDAL, Licensee Portal under Authorizations. If you are not licensed by this Board, but are qualified to provide clinical supervision, email [email protected] to obtain an application. 

IMPORTANT: including clinical supervision continuing education on your licensure renewal application will not update your information on the registry.  The requirements for inclusion on the registry can be found in A.A.C. R4-6-213 and R4-6-214. 

TO OPT OUT of appearing on the registry, or if you are no longer planning to provide clinical supervision and wish to be removed, please send an email to [email protected] requesting removal.

Please note that beginning with the compliance period ending on or after 01/01/18, upon meeting the educational requirements in A.A.C. R4-6-214, the compliance period will be extended for three years as opposed to the next license expiration date.

Documentation:

Supervisors and supervisees are responsible to ensure documentation of clinical supervision sessions meets the Board's requirements in A.A.C. R4-6-212.  A sample clinical supervision session form is provided below as a resource, but is not mandatory.  The form was developed through a task force between the Board and the Arizona Department of Health Services. 

Sample clinical supervision session form

If an exemption is required for a clinical supervisor not employed at the same agency as the supervisee, a sample contact form is provided below which would meet requirement A.A.C. R4-6-212.01(1)(b)(i)(ii). This form my be used by the agency/clinical supervisor as a stand alone document, however it is not required.

Sample Clinical Supervision contract form
 
Resources:
 

If you chose to appear on the Clinical Supervisor Registry, you can view your compliance dates on the Licensee Portal if you click on Authorizations, or the License Verification page.