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 64B4-3.0085 - Intern Registration

(1) An individual who intends to practice in Florida to satisfy the post-master's experience must register as an intern by submitting a completed application to the Board on Form DH-MQA 1175, Application for Registration as a Registered Intern for Clinical Social Work, Marriage & Family Therapy or Mental Health Counseling (Revised 8/2020), hereby adopted and incorporated by reference, which can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-12733, or the web at www.floridasmentalhealthprofessions.gov/resources. The application shall be accompanied by the application fee specified in Rule 64B4-4.015, F.A.C., which is non-refundable.

(2) An intern is required to identify a qualified supervisor by requesting that the supervisor submit a letter to the Board with the applicant's name, supervisor's name, supervisor's license number, and a statement that he or she has agreed to provide supervision while the applicant is a registered intern.

(3) Prior to changing or adding another qualified supervisor, the registered intern must:

(4) Experience obtained under the supervision of a qualified supervisor will not count toward completion of the experience requirement until the registered intern has received board approval of the qualified supervisor.

(5) A registered intern must complete all hours associated with their clinical practicum, either through their graduate program or under the supervision of a qualified supervisor, before any hours completed toward the registered intern's experience requirement may be counted.

(6) Form HD5044-MQA, Supervision Plan Form for Registered Clinical Social Work Interns Form (Revised 02/20), hereby adopted and incorporated by reference, which can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-12734, or on the web at www.floridasmentalhealthprofessions.gov/resources, may be submitted by a qualified supervisor as an acceptable supervision plan for meeting the clinical practicum hours required for licensure if not otherwise satisfied by the individuals' graduate program.

(7) Form HD5046-MQA, Graduate-Level Practicum, Internship, or Field Experience Verification Form - Clinical Social Work (Revised 02/20), hereby adopted and incorporated by reference, which can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-12736, or on the web at www.floridasmentalhealthprofessions.gov/resources, must be submitted by a qualified supervisor on behalf of the Clinical Social Work registered intern upon completion of the practicum, internship, or field work required for licensure when not satisfied by the individuals' graduate program.

(8) Form HD5045-MQA, Graduate-Level Practicum, Internship, or Field Experience Verification Form - Marriage and Family Therapy (Revised 10/20), hereby adopted and incorporated by reference, which can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-12735, or on the web at www.floridasmentalhealthprofessions.gov/resources, must be submitted by a qualified supervisor on behalf of the Marriage and Family Therapist registered intern upon completion of the practicum, internship, or field work required for licensure when not satisfied by the individuals' graduate program.

(9) Form HD5047-MQA, Graduate-Level Practicum, Internship, or Field Experience Verification Form - Mental Health Counseling (Revised 02/20), hereby adopted and incorporated by reference, which can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-12737, or on the web at www.floridasmentalhealthprofessions.gov/resources, must be submitted by a qualified supervisor on behalf of the Mental Health Counseling registered intern upon completion of the practicum, internship, or field work required for licensure when not satisfied by the individual's graduate program.

(10) For a Registered Intern to be eligible for a one-time exception due to an emergency or hardship, pursuant to Section 491.0045(6), F.S., the registered intern must have completed the following:

(11) No later than 30 days prior to the expiration of the internship registration, the Registered Intern shall submit, form DH5065-MQA, Registered Intern Exception Request Form (Revised 5/2023), hereby adopted and incorporated by reference, which can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-15366, or on the web at www.floridamentalhealthprofessions.gov/resources. Upon receipt of timely filed, fully completed and signed Registered Intern Exception Request Form, the Board shall issue the registered intern a one-time exception by granting an extension of their registration status for 24 months from the date of the initial registration expiration. No further exceptions or extensions are authorized by Section 491.0045, F.S.