Mental Health Counselor Form 4 Application for Experience Record - New York

Mental Health Counselor Form 4 Application for Experience Record - New York

What Is Mental Health Counselor Form 4?

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.

FAQ

Q: What is the Form 4 Application for Experience Record?
A: The Form 4 Application for Experience Record is a document required for mental health counselors in New York to record their supervised experience.

Q: Who needs to fill out the Form 4 Application for Experience Record?
A: Mental health counselors in New York who are applying for licensure by experience need to fill out this form.

Q: What information is required in the Form 4 Application for Experience Record?
A: The form asks for details about the type of counseling experience, the supervisor's information, and the dates and number of hours worked.

Q: Who should I contact if I have questions about the Form 4 Application for Experience Record?
A: If you have questions about the Form 4 Application for Experience Record, you can contact the New York State Education Department's Office of the Professions.

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Form Details:

  • Released on February 1, 2019;
  • The latest edition provided by the New York State Education Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Mental Health Counselor Form 4 by clicking the link below or browse more documents and templates provided by the New York State Education Department.

Download Mental Health Counselor Form 4 Application for Experience Record - New York

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