Using Employment Verification Form to Document Work Experience

The following guidelines apply to this form:

  • Each submitted form must contain: the dates of employment; hours worked per week; name and address of the company; and the supervising professional’s name, license number, license issue date/expiration date, original signature, and date.
  • Each form must not contain any alterations or corrections. The Board will not accept or evaluate a form that contains corrections.
  • Candidates may photocopy blank forms; however, the signature must be original. The Board will not accept or evaluate forms without original signatures.

Candidates should keep current on their submissions of the Employment Verification Form. The Board recommends that candidates keep a supply of forms on hand and submit one at least every six months.

When the Board receives a new Employment Verification Form, an evaluation update is completed and a notice is mailed to the candidate advising of his or her current file status. Candidates may request an update of their status at any time throughout the year.