Associate hours · relationship ending · reviewed 28 August 2026
Experience verification closeout
A departure record for obtaining and checking experience verification before access disappears.
Use the resource →Use when leaving an employer, changing supervisors, or finishing a period of supervised experience.
This is a preparation aid, not the Experience Verification form submitted to the Board.
Recheck the source links before relying on an older saved copy. Entries stay in this open page. Copy or print the working copy before leaving.
Working resource
Make the invisible facts visible.
Review point 01
Select the correct Board form
Use the current form for AMFT, ASW, or APCC experience and the applicable in-state or out-of-state path.
Review point 02
Reconcile dates
Compare first and last dates across agreements, weekly logs, payroll, and your own total.
Review point 03
Reconcile categories
Confirm that category totals can be traced back to contemporaneous weekly records.
Review point 04
Resolve corrections before signature
Document why a total changed and preserve the corrected signed record.
Review point 05
Record delivery and custody
Note who completed the verification, when it was delivered, and where your copy is secured.
Review point 06
Preserve contact continuity
Keep an organization-level route for later questions without placing personal details in this worksheet.
Private working copy
Carry the review into your own next action.
Your entries remain only in this open page. They are not saved, uploaded, transmitted, or placed in the URL. Use a non-identifying reference—not a client name.
Your working copy
Controlling material
Read the authority, not merely the worksheet.
Educational information only; not legal, clinical, tax, billing, or regulatory advice. A resource cannot resolve facts it was not given or authority that changed after the review date.
