Peer Support Supervision

Peer Support Supervision

RSPS/MHPS
Name

First NameLast Name
Date

MonthDayYear
Date
Peer Support Supervision

Before starting Peer Support Supervision, you need to have completed your initial application for RSPS or MHPS certification and have received an approval email from the Texas Certification Board (TCB) approving you to begin your supervised 250 work experience hours.Part of the certification process for both Mental Health Peer Specialists and Recovery Support Peer Specialists is the completion of 250 hours of volunteer or paid work experience specific to MHPS or RSPS.These hours must be completed under the supervision of a Peer Specialist Supervisor.Internal or external supervision can be provided, which means that the supervisor overseeing your hours does not have to work in the same organization where you are completing your 250 hours.
Applicant Eligibility Check List:
I am 18 years of age or older *
*
Yes No
I have a high school diploma or GED yes no*
I am a person with lived experience with my OWN substance misuse/Mental Health Challenges: Yes No*
I have accessibility needs (such as hearing, visual, executive or other considerations) * yes No
If Yes, please describe
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Birth

MonthDayYear
Date of Birth

We reserve the right to determine participation in our Peer Supervision
I have read and understood all of the items in this application and attest that I, myself, filled it out I agree*
Signature*
Please verify that you are human*
Peer Supervision Appointment*

My Products

Peer Support Supervision Peer Support Supervision for newly certified MHPS/RSPS

$500.00 Quantity

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Total

$0.00

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Applicant Eligibility Check List: