FAQ

Please complete this form if you are interested in supervision towards earning/maintaining your credential in behavior analysis. I am a BCBA, QBA, and IBA who is licensed in Alabama, Maryland, and Virginia.

Name (Required)

First Last

Address (Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone (Required)

Email (Required)

Which board are you seeking a credentialed with? (Required)

Behavior Analyst Certification Board

International Behavior Analysis Organization

Qualified Applied Behavior Analysis Credentialing Board

Where are you in your coursework towards becoming a behavior analyst? (Required)

I haven’t started yet

I’m in the midst of my coursework

I have completed my coursework

Do you currently have errors and omissions (malpractice) insurance that covers the practice of applied behavior analysis? (Required)

Have you taken a coursework in human trafficking? (Required)

Have you taken coursework in cultural issues? (Required)

Have you taken coursework in LGBTQIA+ health, diversity & inclusion? (Required)

Have you taken coursework in ethics? (Required)

Have you taken coursework in supervision? (Required)

Have you completed supervision hours with another supervisor? (Required)

If you have completed hours with another supervisor, have you/do you plan to continue working with the other supervisor as well?

If you have completed hours with another supervisor, how many RESTRICTED hours do you have?

If you have completed hours with another supervisor, how many UNRESTRICTED hours do you have?

If you have completed hours with another supervisor, do you have all monthly forms from the other supervisor, and/or your form for the conclusion of that supervision.

What questions do you have?

NOTICE: The current fees associated with supervision for the credentials related to the BACB, IBAO, or QABA Board are $100 per hour. This fee is to be paid to Breakthrough Developmental Services, LLC and not to the person providing your supervision. No discounts for this service are available.

The “Supervisory Period” is set by the board as 1-month of time. To make this easier, we utilize a calendar month. The supervisor and the supervisee will need to have 4 to 6 Supervisor-Trainee contacts each month based on the type of fieldwork you are completing for the month. For most boards, at least 5% of your hours need to be supervised per supervision period. You are free to meet remotely, or in person. Additionally, the Supervisor will need to observe you working directly with patients/clients in some situations. This time counts into your supervised hours for each period. Please speak with the supervisor directly to determine your exact schedule and more information concerning this.

AUTHORIZATION: By submitting this form, you give Breakthrough Developmental Services or our representatives permission to contact you. Submission of this form is not a contract and does not obligate you to begin supervision with Breakthrough Developmental Services.

Interested in Supervision?

Request for Supervision Form