Florida Administrative Code
64 - DEPARTMENT OF HEALTH
64B4 - Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling
Chapter 64B4-3 - LICENSURE - CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING APPLICANTS
Section 64B4-3.0015 - Verification of Supervised Experience for Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Applicants

(1) Every applicant for licensure by examination as a clinical social worker, marriage and family therapist or mental health counselor shall verify the required supervised experience on Form DH-MQA 1181, "Verification of Clinical Experience" (Revised 05/2021), which is hereby adopted and incorporated by reference and is available from http://www.flrules.org/Gateway/reference.asp?No=Ref-13497, or the web at www.floridasmentalhealthprofessions.gov/forms/clinical-exp-verification.pdf. This form is to be completed and signed by the applicant's supervisor.

(2) Applicants for licensure in Clinical Social Work, Marriage and Family Therapy or Mental Health Counseling who cannot provide verification by the methods above will be reviewed on an individual basis as to the sufficiency of alternative verification.