How to fill out the monthly fieldwork verification form

Fill out the form in ten steps

These steps follow the 2027 individual supervisor version, which applies if you apply on or after 1 January 2027. The 2022 version and the multiple supervisors version ask for the same hours with small differences, noted below.

1. Pick the right version. Use the 2027 form if you will apply on or after 1 January 2027 and the 2022 form if you will apply before. Use the individual supervisor form for one supervisor, or the multiple supervisors at one organization form when one responsible supervisor coordinates several. If you do not yet know when you will apply, the transition guidance suggests completing both the 2022 and the 2027 forms each month.
2. Close the month in your log first. Add up the month for this supervisor only: independent time, supervised time split into individual and group, and the total minutes a supervisor observed you with a client. Keep the group and individual split in your own records even though the form does not ask for it.
3. Check every monthly rule before anyone signs. Under 2027 the month needs 20 to 160 hours, at least 5 percent supervised (7.5 for concentrated), no more than half of supervision in groups, and 60 minutes of observation (90 for concentrated). If a rule is not met, agree with your supervisor how the handbook's adjustment table reduces the hours before the form is completed.
4. Open the form in Adobe Acrobat Reader on a computer. The form says it may be completed in Adobe Acrobat Reader on a desktop but not in a web browser, because its drop-down menus and dates do not save correctly there. You can also print it and write over the drop-downs.
5. Fill in the identity fields. Your name, your ID from your account on the certifying board's portal, the month and year, the state and country where the fieldwork happened, and your supervisor's name with their certification number or ID.
6. Enter independent and supervised time. Line A is independent hours, with the supervisor not present. Line B is supervised hours, with the supervisor present, individual and group together. Each takes hours and minutes. Record actual time, never time multiplied by the 1.33 concentrated factor.
7. Enter the observation time. The 2027 form asks how many hours and minutes of the fieldwork were observation of you with a client. This is included in your hours, not added on top.
8. Check the total and the percentage. The form adds A and B and divides supervised by total. Check both against your own figures. A percentage of 4.96 is not 5, so a month that shows just under the threshold does not meet it.
9. Save, reopen and check. Save the file, close it and open the saved copy to confirm every field kept its value. Forms with missing information are denied, and an incomplete form can mean the month's hours are lost.
10. Sign by the deadline and keep your copy. The supervisor and the trainee sign and date the form by the last day of the calendar month after the month of supervision, using a signature the Acceptable Signatures Policy allows. Each of you keeps a copy for at least 7 years. Do not submit it unless the board asks.

What the monthly form is for

The monthly form is the record that a month of fieldwork met the requirements. It is signed monthly but kept, not submitted. When a supervision relationship ends, your supervisor signs a final fieldwork verification form built from the signed monthly forms, and the final form is what goes with your certification application. The monthly forms are what you produce if your fieldwork is audited.

A missing month cannot be rebuilt later: if a monthly form is lost, the documenting fieldwork FAQ says those hours should not be counted.

How the 2022 and 2027 versions differ

• The 2027 form has a line for the hours and minutes of observation. The 2022 form confirms an observation happened instead, because the 2022 rule is one observation a month rather than 60 or 90 minutes.
• The 2022 form asks you to tick supervised or concentrated fieldwork. On the 2027 form, the percentage supervised and the observation minutes show which type the month meets.
• The 2022 attestation mentions the required number of supervisor contacts. The 2027 tables list no minimum number of contacts.

Whichever version you use, one form covers one supervisor, or one organization's responsible supervisor, for one calendar month. Two supervisors at different places in the same month means two forms, and each month must meet every rule on its own. The full rule set is on the 2027 requirements page.

Worked example: March 2027, one supervisor

A trainee applying in 2028 logs supervised fieldwork in March 2027 with one individual supervisor. Across the month the log shows 112 h 30 m of independent time and 7 h 0 m of supervised time, of which 4 h 15 m was individual and 2 h 45 m was group. The supervisor observed the trainee with clients for 75 minutes in total.

Every rule is met, so the supervisor and trainee sign on or before 30 April 2027. If the same trainee might apply before 2027 instead, the 2022 form for March would also need four supervisor contacts and a total of no more than 130 hours, which this month also meets. You can test your own month the same way in the free monthly checker.

Common mistakes

• Filling the form in a web browser's PDF viewer. Dates and drop-downs may not save, and a form with missing information is denied.
• Signing late. A monthly form signed after the last day of the following month makes the whole month ineligible, and no adjustment brings it back.
• Writing concentrated hours multiplied by 1.33. Forms always record actual hours; the multiplier is only for estimating your progress.
• Putting two supervisors on one individual form. Each supervisor signs their own form for their own hours.
• Rounding the percentage up. 4.96 percent is below 5, and the month does not meet the rule until supervised time is added or independent time is adjusted.
• Counting a recorded session the supervisor watched later, without real time feedback, as supervised time. It can count toward observation, but not toward supervised hours or contacts.
• Keeping only the form. Your own records still need every session, the individual and group split, and whether each activity was restricted or unrestricted.

Check your own months

The free monthly checker tests one month's numbers against every rule as you type, with the exact shortfall. The log keeps every session and checks each month for you, privately in your browser.

Sources

Last reviewed 26 September 2026 against:

• 2027 Monthly Fieldwork Verification Form: Individual Supervisor, Behavior Analyst Certification Board, form version 06/2026, read 25 September 2026. Used for: The fields on the 2027 monthly form and its instructions. The form is downloaded from the publisher, never from this site.
• Board Certified Behavior Analyst Handbook, Behavior Analyst Certification Board, updated 06/2026, read 25 September 2026. Used for: Supervised Fieldwork Requirements, pages 14 to 25: hours, activities, supervision, documentation, verification forms, adjustments and audits.
• 2027 BCBA Requirements, Behavior Analyst Certification Board, updated 02/2026, read 25 September 2026. Used for: The 2027 overview of fieldwork requirements and the list of 2027 monthly and final forms.
• Guidance for Meeting the BCBA Requirements During the 2027 Transition, Behavior Analyst Certification Board, updated 01/2026, read 26 September 2026. Used for: Meeting both rule sets at once, which forms to keep, and how concentrated hours and the monthly maximum carry across.
• Documenting Fieldwork: Helpful Answers to Your FAQs, Behavior Analyst Certification Board, updated April 2026 for the 2027 requirements, read 25 September 2026. Used for: Correcting a signed monthly form, lost forms, the 1.33 multiplier and which supervisor signs.

This guide is our own summary, not advice about your eligibility. If it disagrees with the current documents, the documents win. Fieldwork Ledger is not affiliated with, endorsed by, or connected to the Behavior Analyst Certification Board or any other certifying body.