What do I need to make certain to do? CCCs At Last!
What do I need to make certain to do?
CCCs At Last!
ASHA Guidelines ! Paperwork is ultimately your responsibility.
! Follow up. Follow up. Follow up.
! Who should you follow up with?
! Supervisor
! ASHA
! Send Return Receipt - trackable mail
ASHA Guidelines • Getting your CF approved
! www.asha.org/certification/GettingCFApproved.htm
! CFSI - Clinical Fellow Skills Inventory - worksheet for supervisor (link to pdf)
! Must have a ‘3’ or above on the identified core skills in the final segment.
! CF is no less than 36 weeks of Full-time work experience
! Supervisor held CCC during the entire CF supervision
ASHA Guidelines An Application for Membership and Certification must be submitted at this time if you have not already done so.!!►A separate SLPCF Report and Rating Form must be submitted for each change in mentor, location, or regularly scheduled hours worked per week.!!►All blanks and boxes must be filled in. Incomplete Report & Rating forms will be returned and will delay the processing of your application.!!►A full-time SLPCF consists of a minimum of 35 hours worked per week and equals 1,260 hours throughout the 36-week SLPCF. The SLPCF must consist of at least 36 mentoring activities, including 18 hours of on-site direct client contact observations and 18 other monitoring activities.!!►Professional experience of less than 5 hours per week cannot be used to meet the SLPCF requirement.!!►Use black ink only when completing this form. Print all information clearly.!
Alabama State Guidelines Completion paperwork to be submitted within
30 days of the completion of the Supervised Professional Experience
• Licensure Fee $75 • * Mail Return receipt or Certified Mail* • 1. Undergraduate and graduate transcripts • 2. Results of the national examination (see below). • 3. A notarized statement from the supervisor indicating that the
Professional Experience (CFY) has been completed. ! Number of hours per week worked ! Place of employment ! Supervisor's name ! AL license number or CCC or its equivalent. • 4. A letter from the director of training program verifying that I
have completed the required hours of direct clinical experience with individuals with communication
• disorders.
Alabama State Guidelines Comple'on paperwork to be submi3ed within
30 days of the comple'on of the
Supervised Professional Experience • Licensure Fee $75 • Common Omissions when SubmiGng the Licensure Applica'on
Form: • * A le3er from the director of the educa'onal program verifying
that requirements prior to supervised clinical experience have been completed.
• * Notarized le3er from CFY or 4th Year Internship Supervisor containing: number of hours per week worked, place of employment, supervisor's name & AL license number or CCC or its equivalent.
• * Undergraduate and Graduate Transcripts. • Another common misunderstanding is that there are TWO
SEPARATE FEES: an applica'on fee (which is $200), and a licensure fee (which is $75). The applica'on fee is due with the applica'on. The licensure fee may be paid at that same 'me or paid once the applica'on is approved for licensure.
• * Mail Return receipt or Cer'fied Mail*
Florida State Guidelines
! www.doh.state.fl.us/mqa/speech/
! Supervisor must complete Forms
! SPA-2B: Supplemental Eval for every 3 months
! SPA-2C: Supervisor Report
! $280 (2012)
! Initial License Application
Florida State Guidelines
1. Complete the Confidential and Exempt From !Public Records Disclosure Form!!2. Attach a recent 2x2 color photo (above shoulders )!!3. Sign and date application!!4. $280 Fee (check/money order for application, !licensure and unlicensed activity fees )!!5. Proof of 1-hour HIV/AIDS course !(free on www.SpeechPathology.com or offered by !any healthcare profession ) CODE: COBB13!!6. Proof of 2-hours prevention of medical errors course (free on !www.SpeechPathology.com from an approved !Board of Speech-Language Pathology!and Audiology continuing education provider )!!7. SPA-2B Supervisory Evaluation for every 3 months (need 3 forms)!!8. SPA -2C Supervisory Report (summary)!
Georgia State Guidelines All documentation must be sent to the
Georgia Licensing Board within 14 days of completion of the PCE.
• www.sos.georgia.gov • Final Procedure once PCE is complete:
1. Fill out completion of PCE with Supervisor 2. Fill out permanent license application 3. Attach check to the top of application by examination 4. Send check made out to Georgia State Board of Speech-Language
Pathology/Audiology for $110 5. Mail Return receipt or Certified Mail.
• Completion application form: http://sos.georgia.gov/acrobat/PLB/10%20Documentation%20for%20Completion%20of%20Paid%20Clinical%20Experience.pdf
South Carolina State Guidelines
! www.llr.state.sc.us
! Report of Completed Internship
! Application for License *Notarized*
! Fee $220
! Proof of Identity - Photo ID, Driver’s license
Maryland State Guidelines
http://dhmh.maryland.gov/boardsahs/SitePages/Home.aspx INSTRUCTIONS FOR APPLYING FOR A FULL LICENSE: 1. Website above click on Professionals Licensing Information Speech-Language Pathology License Forms Link download Speech-Language Pathology Application For Full Licensure. 2. Have completed application notarized. 3. Submit Form AS2 Verification of Supervision for Limited Licensure Clinical Fellowship Year for each place of employment during the period of limited licensure. 4. Submit Form AS3 Verification of Satisfactory Completion of Clinical Fellowship Year. 5. If you currently have or have ever been licensed in any other state, complete Form AS4. Request the State licensure Board of that state to return the completed form to the Maryland Board office. 6. Submit $150.00 fee (make check or money order payable to Board of SLP). 7. Submit a recent 2x2 passport size photo 8. Completed Law Exam (see # 7 under Instructions For Applying For a Limited License) 9. Transcripts, Undergraduate Transcript, Clinical Fellowship Year Plan (Form AS2), Clinical Fellowship Year Verification (Form AS3), and Praxis Exam Scores.
Virginia State Guidelines
• Already have a permanent license!
• Congratulations!
Summer Thoughts... ! Organize materials
! Build Language Units
! Surf Therapy Websites to become familiar
! Build ‘Therapy on a Dime’ materials
! Organize any computer files so they are easily found during the year.
Have a GREAT Summer Break!!
Congratulations!