Supervised private practice

Effective January 12, 2019, Board rules related to direct supervision have been modified.  The rule changes to A.A.C. R4-6-211 expand the settings where masters level non-independent licensees may practice under supervision to include a practice they own or manage (with appropriate clinical supervision).  Pursuant to A.A.C. R4-6-306(F), the Board has determined that temporary licensees who have been approved to test, but haven't yet taken and passed the exam are restricted from supervised private practice.

To view the modified version of A.A.C. R4-6-211 (effective January 12, 2019) and related terms, click HERE.

Prior to beginning supervised private practice, Board approval is required.  To request approval, complete the form below and submit the form and your signed supervision agreement by mail, fax, or email.  A sample agreement is also provided below.

Request for approval of Clinical Supervisor  - form may be dropped off or mailed to the Board's address, faxed to (602) 364-0890, or sent via email to

Sample supervision agreement - this template is provided as a sample only and contains the information required in Board rule, however additional stipulations may be included as the parties deem appropriate.  There are additional contract requirements if the clinical supervision provided will be submitted to meet the supervised work experience for independent licensure pursuant to A.A.C. R4-6-212.01.

Verification of Supervision - Upon approval, supervisors/supervisees will be notified of the due dates for their supervision reports (submitted every six months).