Two pages, 26 weeks each, with a total at the bottom of every page. Print as many as you need for your 36 months or more.
Download the log (PDF)What to write each week
- The week, Monday to Sunday
- Client-contact hours: diagnosis, psychotherapy and assessment-based treatment planning. Case management, advocacy or discharge planning alone do not count.
- Supervision hours, and whether supervision was individual or group, in person or by secure video
- Your supervisor’s initials, so the two of you agree week by week
What it adds up to
2,000 client-contact hours and 100 hours of supervision, over at least 36 months and no more than 6 years. Supervision is spread across the whole period, not bunched at the end. Your supervisor keeps the weekly psychotherapy log NYSED may ask for; this log is your own copy, and it is what makes Form 4B quick when you apply. Every NY LCSW requirement.
Or let the app keep it for you
Licensure Hours keeps the same weekly record on your phone, adds it up as you go, has your supervisor confirm weeks with a link instead of initials, and fills in Form 4B from it when you apply. Free for 30 days, no card.