The Contested Experience/Fieldwork form may be completed when a supervisor refuses or is unable to sign the Final Experience/Fieldwork Verification Form, even though all supervision contract terms have been met. This form may only be used to contest signature of the Final Experience/Fieldwork Verification Form and should not be used to contest signature of Monthly Experience/Fieldwork Verification forms or to appeal a determination made by BACB staff. Information provided in the form may be shared with the supervisor(s) for verification purposes.
Before completing this form, you should:
- Attempt to resolve the matter with your supervisor(s). In the event that the issue is not resolved, retain documentation of your attempt to include with your submission.
- Review the terms of your supervision contract.
- Collect any signed Monthly Experience/Fieldwork Verification forms that you have for the period in question, along with any documentation that provides evidence that supervision took place.
- Determine if there was an ethical violation related to experience/fieldwork which may be reported by filing a Notice of Alleged Violation (NAV).
- Determine if this is a matter of a contractual dispute that may need to be addressed through an independent legal process.