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Hours: you must complete 2,000 client contact hours of post-MSW supervised experience over a period of at least 36 months and no more than 6 years.
Supervisor: you must be supervised by a licensed clinical social worker, licensed psychologist or physician who meets the requirements of section 74.6.
Review: this form will not be reviewed if submitted after the supervised experience has been completed.
Psychotherapy log: use this weekly log to document the applicant's hours of practice and supervision.
| Question | Answer |
|---|---|
| Form Name | Social Worker Form 6 |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 12 min |
| Edition | Rev 11/21 |
| Issuing agency | New York State Education Department, Office of the Professions |
| Where to send | If you are submitting an initial Form 6: New York State Education Department, Office of the Professions, PO Box 22063, Albany, NY 12201 |
| Other names | Form 6, Social Worker Form 6, LMSW Form 6, Plan for Supervised Experience |
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