GENERAL SUPERVISION EVALUATION FORM FOR …
OBLADC form 208 11/2012 1 GENERAL SUPERVISION EVALUATION form FOR DRUG AND ALCOHOL licensure /CERTIFICATION ELIGIBILITY LADC - Typically 50 completed hours of educational SUPERVISION / 2000 completed hours of practice/work hours under SUPERVISION CADC - Typically 100 completed hours of educational SUPERVISION / 4000 completed hours of practice/work hours under SUPERVISION LADC/MH - Typically 50 completed hours of educational SUPERVISION / 2000 completed hours of practice/work hours under SUPERVISION PARTIAL SUPERVISION (Due to a change in status, change of SUPERVISION , change of employment): Number of completed hours of SUPERVISION this EVALUATION :____________ Hours to present date: ____________ SUPERVISEE Other name(s) under which evaluations have been submitted Home Address - Street/Ci
OBLADC Form 208 11/2012 1 GENERAL SUPERVISION EVALUATION FORM FOR DRUG AND ALCOHOL LICENSURE/CERTIFICATION ELIGIBILITY LADC - Typically 50 completed hours of educational supervision / 2000 completed hours of practice/work hours under supervision CADC - Typically 100 completed hours of educational supervision / …
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Your State allow persons licensed in, Medical, CARLO PAPPONE, MD, PhD, FACC, OVERVIEW, State, Oklahoma State Board of Medical Licensure and, Oklahoma State Board of Medical Licensure and Supervision, Oklahoma, OKLAHOMA ADMINISTRATIVE CODE TITLE 435., Oklahoma administrative code . title 435. state board of medical licensure, Supervision . chapter 30. occupational therapists