Admin: Supervisee Checklist Clinical Supervision Checklist Clinical Trainee Name * Courtney Ramirez lauren chow testfirst last Current progress in training State Seeking Licensure License Type(s) Clinical Supervisee’s Malpractice Insurance Expiration Date * Trainee’s Resonant Email On-Boarding: Required before seeing clients Status done n/a New Supervisee Form Resonant Clinical Supervisee InformationResonant Clinical Supervisee AgreementSupervisee Malpractice InsuranceResumeSchool TranscriptPhoto (optional)Program Insurance PolicyProgram Site Placement AgreementIRS W-4 and I-9 forms (only if paid employee)Background CheckLiveScanProgram Hours Tracker Access EstablishedTelehealth Training (through Resonant Equity)Defensive Documentation Training (through Resonant Equity)Antiracism in Counseling Training (through Resonant Equity)OpenPath Profile Due By Completed On Link Notes plus1 Add minus1 Remove Supervisor-Specific Requirements – California BBS For those on the LPCC track: These forms are only relevant for Registered Associates (not trainees). If you are also pursuing the LMFT then you will need these forms even as a trainee. When needed, each supervisor will provide a full set of forms. While Resonant Counseling is responsible for meeting our supervisory requirements for you, please note that it is up to you, the one seeking licensure, to be sure all your licensing requirements are met and your necessary forms are completed. Supervisor Name * Lisa Wenninger, LPCC 14315 Supervision Start * End BBS Forms & Documents Supervision Agreement (BBS form – required for ALL Associates) Verification of Employment of Supervisee as a Volunteer (only needed when supervisee is a volunteer) Written Oversight Agreement (only needed when supervisor is a volunteer) If an item is checked, then the Associate will need to include the document with their BBS application for licensure. The Associate gets the signed original. BBS Requirements – Resonant Counseling Internal Processes Telesupervision Assessment Annual Review While the above items are technically only required for Registered Associates, Resonant Counseling uses the same process for all pre-licensed clinicians. None of these forms or documents get submitted to the BBS; they are maintained internally only. Notes plus1 Add minus1 Remove Submit If you are human, leave this field blank.