Maine Prevention Certification Board Documentation of Supervision for Certified Prevention Specialist (PS-C)
In cases where an applicant has been supervised by multiple supervisors (due to multiple employers/programs), each supervisor should fill out a separate form.

Certified Prevention Specialists must have 120 hours of Supervision in the Prevention Performance Domains, with a minimum of 10 hours in each domain. The person or persons supervising the applicant should complete this form.

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