Information for Supervisors

Clinical Supervisor Requirements

To provide clinical supervision, an individual must:

Individuals who would like to be added or updated on the Clinical Supervisor Registry, or who would like to have their education reviewed shall submit the Clinical Supervisor Registration form and required documentation.  IMPORTANT: including clinical supervision continuing education on your licensure renewal application will not update your information on the registry.  The requirements for inclusion on the registry can be found in A.A.C. R4-6-213 and R4-6-214. 

TO OPT OUT of appearing on the registry, or if you are no longer planning to provide clinical supervision and wish to be removed, please send an email to requesting removal.

Please note that beginning with the compliance period ending on or after 01/01/18, upon meeting the educational requirements in A.A.C. R4-6-214, the compliance period will be extended for three years as opposed to the next license expiration date.


Supervisors and supervisees are responsible to ensure documentation of clinical supervision sessions meets the Board's requirements in A.A.C. R4-6-212.  A sample clinical supervision session form is provided below as a resource, but is not mandatory.  The form was developed through a task force between the Board and the Arizona Department of Health Services.

Sample clinical supervision session form