Form 37A-301: Marriage and Family Therapist In-State Experience Verification

Form 37A-301 PDF Details

Ensure that the form is complete and correct prior to signing.

Pre-degree and post-degree: Use separate forms for pre-degree and post-degree experience.

Supervisors and settings: Use separate forms for each supervisor and each employment setting.

Weekly Log: Do not submit Weekly Log forms unless specifically requested.

Pay: For hours gained as an Associate ONLY, if the applicant was receiving pay, they must submit a copy of their W-2 statement for each year experience is claimed.

Signature: Original or electronic signature required.