MLADCs and candidates for MLADC’s shall:

1. (a) Provide a copy of Alc 406.04 and Alc 406.05 to their clinical supervisors;
2. (b) Maintain records of the dates and hours they receive clinical supervision and the name(s) of the supervisor(s); and

3. (c) On the basis of such records, prepare a cumulative statement containing the following:

   1. (1) For each week identified by calendar date, the number of hours of supervision received and the number of hours in each supervision session;
   2. (2) The credentials, printed name(s), signature(s) of the supervisor(s) providing the clinical supervision, and the date the statement was signed by the supervisor(s); and
   3. (3) The signature of the MLADC or candidate for MLADC preparing the statement and the date of the signature.

Source. #12548, eff 7-1-18; ss by #14045, eff 10-7-24