Supervision Contract and Consent FormSupervision Contract • August 15th, 2023
Contract Type FiledAugust 15th, 2023as the supervisee) and Kim Bass, LPC, CSPC (herein after referred to as the supervisor). The supervisor agrees to provide supervision in compliance with the requirements for the Licensed Professional Counselor (LPC) license in the State of Georgia and in accordance with the terms below. The parties mutually agree to the following: