ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
2
(A) DIRECT SERVICE : Clinical Work and DevelopmentNumber of hours
3
1. Direct Client Contact Hours (min. 50 total)
4
a) not observed by an NMT™
5
b) observed by an NMT™
6
2. Assessment Hours
7
3. Implementing NMT™ Technique
8
4. Observation of another NMT™
9
5. Supervision Hours (formal and in-formal) meetings (min. 10)
10
TOTAL DIRECT SERVICE HOURS (min. 50 hours, sum of items 1 to 5)
11
(B) ADMINISTRATION
12
6. Documentation Hours
13
7. Planning/Resource Development Hours
14
8. Total Non-Client Specific Meeting Hours
15
9. Total NMT™ In-service Hours
16
10. Total Continuing Education Hours
17
TOTAL ADMINISTRATION HOURS (max. 30 hours total, sum of items 6-10)
18
17. TOTAL CLINCAL HOURS (A + B)
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100