The BBS Experience Verification form: who signs it, when, and what it asks

Which form

• LMFT (for AMFT hours): 37A-301, Revised 11/2024; for hours outside California, 37A-304
• LCSW (for ASW hours): 37A-201; for hours outside California, 37A-202
• LPCC (for APCC hours): 37A-675, Revised 10/2024; for hours outside California, the form printed 37A-668 (its file is named “37a-677”)
• The Board accepts all versions of the form (Application for Licensure, 37A-318)

Who fills it in and who sends it

The form says: “This form is to be completed by the applicant's California supervisor and submitted by the applicant with their Application for Licensure.” The rule behind it is the same for all three licenses: completed hours are documented at the end of supervision and submitted by you when you apply for the license (16 CCR 1833(e) for MFTs, 1869(e) for ASWs, 1820(e) for APCCs).

Don't send it with your associate application. The Board's FAQ: “All supervision-related forms must be submitted with your Application for Licensure. Do not send these forms in with your Associate application.”

When should my supervisor sign it?

When the supervision ends. The Board's FAQ: “Have your supervisor sign your Experience Verification form immediately upon conclusion of supervision. Don't wait until a later date, as unforeseen issues can arise with obtaining signatures later.”

One form per supervisor, per setting

• A separate form for each supervisor and each employment setting
• MFT hours: separate forms for pre-degree and post-degree experience
• Two supervisors at one job: your work hours may all go under your primary supervisor, but supervision your second supervisor gave you goes on their own weekly logs and their own Experience Verification (the Board's FAQ)

What the LMFT form asks

• You: your name and AMFT number, whether the hours are pre-degree or post-degree, and the dates
• Your supervisor: name, email, phone, license type and number, and the date first licensed (with their out-of-state license information if they had held a California license under two years on the first date you claim); a physician's ABPN certification
• Whether your supervisor was employed by your employer and, if not, whether an oversight agreement was signed
• Your employer's name and address, whether it is a private practice or professional corporation, and whether you were paid (W-2) or a volunteer
• The number of weeks, total direct clinical counseling hours (and of those, hours diagnosing and treating couples, families and children), and total non-clinical hours (and of those, individual or triadic and group supervision)

The hour lines on the LCSW and LPCC forms

• LCSW (37A-201): hours of clinical psychosocial diagnosis, assessment and treatment (and of those, face-to-face individual or group psychotherapy); hours of client-centered advocacy, consultation, evaluation, research, workshops and direct supervisor contact (and of those, individual or triadic and group supervision)
• LPCC (37A-675): total direct clinical counseling, and total non-clinical experience (and of those, individual or triadic and group supervision)

Signatures

• Your supervisor signs under penalty of perjury (16 CCR 1833(e))
• The MFT and LPCC in-state forms ask for an original or electronic signature; the LCSW in-state form and the out-of-state forms accept original, scanned or electronic. The Board's FAQ accepts all three
• Your supervisor initials any changes
• You may not sign for your supervisor, on the weekly logs or on this form (the Board's Winter 2026 newsletter)
• False or omitted information can be grounds for denying the application

Can I send my weekly logs instead?

No. The Application for Licensure: “Weekly Logs CANNOT be accepted in place of an Experience Verification form.” Keep your weekly logs, signed by your supervisor each week, and send them only if the Board asks.

California AMFT supervision: the weekly rule and the Weekly Log of Experience Hours

What goes with it

• For paid post-degree hours: your W-2 for each year and each employer (a current pay stub if you don't have this year's W-2 yet); if the employer's name on a W-2 doesn't match the form, an explanation
• For volunteer post-degree hours: a letter from your employer verifying your volunteer status
• Neither the W-2s nor the volunteer letter is needed for out-of-state experience
• Workshop and training hours go on the form itself; don't send other proof of completion

Hours gained outside California

Hours gained in another state or country go on the out-of-state form, completed by that supervisor: with an out-of-state application (Path B), or with an in-state application that includes some out-of-state hours (the Application for Licensure: “If you have any Out-of-State experience, use an Out-of-State Experience Verification form”). The supervisor certifies that the hours met the rules of the state or country where you earned them. The MFT out-of-state form prints the license's overall minimums, not a minimum for each form: 104 weeks, 1,750 direct hours (500 with couples, families and children) and at most 1,250 non-clinical hours.

How hours get lost

The Board's FAQ: “applicants can lose experience hours if they are not” signed as required. We haven't found a Board list of common errors on this form; the Board's own tips for keeping your hours are these:

• Follow the 90-day rule after your degree
• Make sure your supervisor meets every requirement
• Work as a W-2 employee or a volunteer, not an independent contractor
• Complete a Supervision Agreement within 60 days of starting with each supervisor
• Have your supervisor sign your log every week
• Gain all your hours within the time limit before you apply: the tips say six years, the rule through December 31, 2026; from January 1, 2027, AB 1598 makes it seven; up to 500 practicum hours are exempt either way
• Clear any deficiency within one year of the letter, or the application is treated as abandoned (16 CCR 1806(a))
• Take the Clinical exam within one year of your approval or your Law and Ethics pass, whichever came later, and within one year of any failed attempt; otherwise you reapply, and only hours within the time limit above can count (16 CCR 1806(b))

California's 2027 LMFT law changes: AB 1598 and SB 1445