This version of the form is not currently in use and is provided for reference only. Download this version of Mental Health Counseling Form 4B for the current year.
This is a legal form that was released by the New York State Education Department - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the purpose of the Form 4B Certification of Supervised Experience?
A: The purpose of Form 4B Certification of Supervised Experience is to certify that an individual has completed the required supervised experience for mental health counseling in New York.
Q: Who is required to fill out and submit Form 4B?
A: Individuals who are seeking licensure as a mental health counselor in New York are required to fill out and submit Form 4B to certify their supervised experience.
Q: What information is included in Form 4B?
A: Form 4B includes information about the supervisor, the supervisee, the dates and duration of the supervised experience, and a statement of the type of activities performed.
Q: What happens after I submit Form 4B Certification of Supervised Experience?
A: After submitting Form 4B, it will be reviewed by the licensing board to determine if the supervised experience meets the requirements for licensure as a mental health counselor in New York.
Form Details:
Download a fillable version of Mental Health Counseling Form 4B by clicking the link below or browse more documents and templates provided by the New York State Education Department.