ELIgIBILITy rEqUIrEmENTS
Updated 04/2024, Copyright© 2024, BACB® | All rights reserved.
Behavior Analyst Certification Board | Board Certified Behavior Analyst® Handbook | 22
In addition to tracking data by session and supervision contact, the documentation system should be regularly
reviewed to ensure that all relevant requirements are met each supervisory period and across all fieldwork hours:
• Each Supervisory Period: The trainee and supervisor should have documentation that shows they are
meeting the quantitative requirements (e.g., minimum number of supervisory meetings and contacts) and
qualitative requirements (e.g., summary of what happened during the supervision meeting).
• Across all Fieldwork Hours: The trainee should have documentation that shows they are accruing the
minimum number of unrestricted hours and making progress toward completing the necessary requirements
for obtaining certification.
Fieldwork Forms: Supervisors and trainees are required to use two forms to verify fieldwork:
• Monthly Fieldwork Verification Form (M-FVF): must be provided to the BACB upon request
• Final Fieldwork Verification Form (F-FVF): must be submitted in the certification application. Please keep in
mind that each F-FVF you submit must show that you met all fieldwork requirements during that organized
fieldwork experience (e.g., fieldwork hours per supervisory period, supervision hours per supervisory period).
Multiple F-FVFs can be submitted to demonstrate that the combined fieldwork experiences meet the total
required fieldwork hours. A new F-FVF should be completed for each supervision experience. Taking a break
from accruing fieldwork under the same supervision contract constitutes a new supervision experience.
Two versions of each form are available and should be selected based upon the supervisory structure (i.e., individual
supervisor, multiple supervisors at one organization). Non-BACB forms will not be accepted.
Individual Supervisor Forms
• Monthly Fieldwork Verification Form: Individual Supervisor
• Final Fieldwork Verification Form: Individual Supervisor
Organization Forms
• Monthly Fieldwork Verification Form: Multiple Supervisors at One Organization
• Final Fieldwork Verification Form: Multiple Supervisors at One Organization
The M-FVF must be signed by the last day of the calendar month following the month of supervision, and we
recommend that the F-FVF be signed at the end of a specific fieldwork experience. Both parties must retain a copy
of the completed fieldwork forms for at least sevenyears. Note: Backdated or retroactively completed forms will not
beaccepted.
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Behavior Analyst Certification Board | Individual Final Fieldwork Verification Form
Version 07/2020 | Copyright © 2020, BACB® | All rights reserved.
FINAL | FIELDWORK VERIFICATION FORM
INDIVIDUAL SUPERVISOR
2022 Fieldwork Requirements
Instructions: Please complete one form per supervisor, per fieldwork type.
Trainee Name: ___________________________________________________________________________
BACB
Account ID: _____________________ Start Date: _____________ End Date: _____________
Fieldwork Type (Select One):
Supervised Fieldwork Concentrated Supervised Fieldwork
State Where Fieldwork Occurred: ________________ Country Where Fieldwork Occurred: _______________
Fieldwork Hours
A. Independent Hours (supervisor not present): __________
B. Supervised Hours (supervisor present): __________
This fieldwork included prorated hours for partial months.
Supervisor and Trainee Attestation
Supervisor Name: _________________________________________________________________________
BACB
Account ID#: _______________________________ Qualification: ____________________________
By signing below, we hereby attest that:
⊲ Information presented on this Final Fieldwork Verification Form and the corresponding Monthly Fieldwork
Verification Forms is true and correct to the best of my knowledge.
⊲ The trainee completed the fieldwork under my supervision in compliance with all relevant Fieldwork
Requirements (BCBA/BCaBA) including, but not limited to; the minimum number of contacts per month, required
amounts of unrestricted activities, required observations each month with clients, and adherence to the BACB’s
ethics requirements.
⊲ I am the supervisor designated in the signed supervision contract with this trainee.
Supervisor Signature: _______________________________________________ Date: ________________
This document must be signed in accordance with the Acceptable Signatures Policy.
SUPERVISOR AND TRAINEE MUST EACH RETAIN A COPY OF THIS FORM FOR AT LEAST 7 YEARS.
Total Fieldwork Hours _______________
(add A & B):
Percent of Hours Supervised _________
(supervised/total):
Note: Please download this form and complete it on your computer’s
desktop rather than in your web browser. This form contains
dropdown menus. If you prefer to print and manually fill out the
form, please write your answers over the dropdowns.
Behavior Analyst Certification Board | Individual Monthly Fieldwork Verification Form
Version 04/2020 | Copyright © 2020, BACB® | All rights reserved.
MONTHLY | FIELDWORK VERIFICATION FORM
INDIVIDUAL SUPERVISOR
2022 Fieldwork Requirements
Instructions: Please complete one form per supervisor, per fieldwork type.
Trainee Name: ___________________________________________________________________________
BACB
Account ID: ______________________ Month/Year: ____________________________________
Fieldwork Type (Select One):
Supervised Fieldwork Concentrated Supervised Fieldwork
State Where Fieldwork Occurred: ________________ Country Where Fieldwork Occurred: _______________
Supervisor Name: ________________________________________________________________________
BACB
Account ID#: _______________________________ Qualification: ____________________________
Fieldwork Hours (this month only)
A. Independent Hours (supervisor not present): __________
B. Supervised Hours (supervisor present): __________
Supervisor and Trainee Attestation
By signing below, we hereby attest that:
⊲ The information contained on this form is true and correct to the best of our knowledge;
⊲ The required number of supervisory contacts occurred during this month;
⊲ Observation of the trainee with a client occurred during this supervisory period with a frequency appropriate for
this fieldwork type;
⊲ The trainee was supervised for the required amount of time for this supervisory period;
⊲ We have read and understand the most recent version of the Fieldwork Requirements (BCBA/BCaBA)
⊲ We are only including appropriate behavior-analytic activities in our totals listed above; and
⊲ The fieldwork hours obtained during this supervisory period are otherwise compliant with the Fieldwork
Requirements (BCBA/BCaBA)
Supervisor Signature: ________________________________________________ Date: ________________
Trainee Signature: __________________________________________________ Date: ________________
This document must bear the signature (see the Acceptable Signatures Policy) of the responsible supervisor and trainee and must be signed by the last day of
the calendar month following the month of supervision.
SUPERVISOR AND TRAINEE MUST EACH RETAIN A COPY OF THIS FORM FOR AT LEAST 7 YEARS.
Total Fieldwork Hours _______________
(add A & B):
Percent of Hours Supervised _________
(supervised/total):
Note: Please download this form and complete it on your computer’s
desktop rather than in your web browser. This form contains
dropdown menus. If you prefer to print and manually fill out the
form, please write your answers over the dropdowns.
Behavior Analyst Certification Board | Organization Final Fieldwork Verification Form
Version 07/2020 | Copyright © 2020, BACB® | All rights reserved.
FINAL | FIELDWORK VERIFICATION FORM
MULTIPLE SUPERVISORS AT ONE ORGANIZATION
2022 Fieldwork Requirements
Instructions: Please complete one form per organization, per fieldwork type.
Trainee Name: ___________________________________________________________________________
BACB
Account ID: _____________________ Start Date: _____________ End Date: _____________
Fieldwork Type (Select One):
Supervised Fieldwork Concentrated Supervised Fieldwork
State Where Fieldwork Occurred: ________________ Country Where Fieldwork Occurred: _______________
Supervisors at the Organization
Supervisor Name: ___________________________ Supervisor Name: ___________________________
BACB
Account ID#: ______________ BACB Account ID#: ______________
Qualification: ___________________ Qualification: ___________________
Supervisor Name: ___________________________ Supervisor Name: ___________________________
BACB
Account ID#: ______________ BACB Account ID#: ______________
Qualification: ___________________ Qualification: ___________________
Supervisor Name: ___________________________ Supervisor Name: ___________________________
BACB
Account ID#: ______________ BACB Account ID#: ______________
Qualification: ___________________ Qualification: ___________________
Fieldwork Hours
A. Independent Hours (supervisor not present): __________
B. Supervised Hours (supervisor present): __________
This fieldwork included prorated hours for partial months.
Responsible Supervisor and Trainee Attestation
Supervisor Name: _________________________________________________________________________
BACB
Account ID#: _______________________________ Qualification: ____________________________
By signing below, we hereby attest that:
⊲ Information presented on this Final Fieldwork Verification Form and the corresponding Monthly Fieldwork
Verification Forms is true and correct to the best of my knowledge.
⊲ The trainee completed the fieldwork in compliance with all relevant Fieldwork Requirements (BCBA/BCaBA)
including, but not limited to; the minimum number of contacts per month, required amounts of unrestricted
activities, required observations each month with clients, and adherence to the BACB’s ethics requirements.
⊲ All supervisors, including the responsible supervisor, met BACB supervision requirements during these
experience hours.
⊲ I am the responsible supervisor designated in the signed supervision contract with this trainee.
Supervisor Signature: _______________________________________________ Date: ________________
This document must be signed in accordance with the Acceptable Signatures Policy.
SUPERVISOR AND TRAINEE MUST EACH RETAIN A COPY OF THIS FORM FOR AT LEAST 7 YEARS.
Total Fieldwork Hours _______________
(add A & B):
Percent of Hours Supervised _________
(supervised/total):
Note: Please download this form and complete it on your computer’s
desktop rather than in your web browser. This form contains
dropdown menus. If you prefer to print and manually fill out the
form, please write your answers over the dropdowns.
Behavior Analyst Certification Board | Organization Monthly Fieldwork Verification Form
Version 04/2020 | Copyright © 2020, BACB® | All rights reserved.
MONTHLY | FIELDWORK VERIFICATION FORM
MULTIPLE SUPERVISORS AT ONE ORGANIZATION
2022 Fieldwork Requirements
Instructions: Please complete one form per organization, per fieldwork type.
Trainee Name: ___________________________________________________________________________
BACB
Account ID: ______________________ Month/Year: ____________________________________
Fieldwork Type (Select One):
Supervised Fieldwork Concentrated Supervised Fieldwork
State Where Fieldwork Occurred: ________________ Country Where Fieldwork Occurred: _______________
Responsible Supervisor Name: _______________________________________________________________
BACB
Account ID#: _______________________________ Qualification: ____________________________
Fieldwork Hours (this month only)
A. Independent Hours (supervisor not present): __________
B. Supervised Hours (supervisor present): __________
Responsible Supervisor and Trainee Attestation
By signing below, we hereby attest that:
⊲ The information contained on this form is true and correct to the best of our knowledge;
⊲ All supervisors, including the responsible supervisor, met BACB supervision requirements during this month;
⊲ The required number of supervisory contacts occurred during this month;
⊲ Observation of the trainee with a client occurred during this supervisory period with a frequency appropriate for this
fieldwork type;
⊲ The trainee was supervised for the required amount of time for this supervisory period;
⊲ We have read and understand the most recent version of the Fieldwork Requirements (BCBA/BCaBA)
⊲ We are only including appropriate behavior-analytic activities in our totals listed above; and
⊲ The fieldwork hours obtained during this supervisory period are otherwise compliant with the Fieldwork
Requirements (BCBA/BCaBA)
Supervisor Signature: ________________________________________________ Date: ________________
Trainee Signature: __________________________________________________ Date: ________________
This document must bear the signature (see the Acceptable Signatures Policy) of the responsible supervisor and trainee and must be signed by the last day of
the calendar month following the month of supervision.
SUPERVISOR AND TRAINEE MUST EACH RETAIN A COPY OF THIS FORM FOR AT LEAST 7 YEARS.
Total Fieldwork Hours _______________
(add A & B):
Percent of Hours Supervised _________
(supervised/total):
Note: Please download this form and complete it on your computer’s
desktop rather than in your web browser. This form contains
dropdown menus. If you prefer to print and manually fill out the
form, please write your answers over the dropdowns.