Clinical Mental Health Counseling and Marriage, Couple, and Family Counseling Practicum and Internship Information
CNS 591 and 596
Please follow the directions for completing and submitting each form. The directions are located at the bottom of each form. All documents must be in PDF format and submitted electronically via e-mail.
- Informed Consent
- Practicum Application Form *
- Practicum Site and Supervision Contract *
- Practicum/Internship Hour Log
- Internship Site and Supervision Contract *
- Plan of Action for Course Completion
- Petition for Change in Practicum or Internship Site
- Student Counselor Evaluation of Supervisor
- Student Evaluation of Site
- Permission to Video
- Site Supervisor Evaluation of Student Performance in Practicum (Midterm and Final)
- Site Supervisor Evaluation of Student Performance in Internship (Midterm and Final)
*: Microsoft Word files marked with an asterisk (*) are forms where only certain fields can be edited.
Directions for working with the Forms
- Make a folder on your computer for "Practicum and Internship forms"
- Right click on each link above and choose "save as", and save the file to the folder you created in the above step.
- After you have saved all the files, go to the folder where you just saved the files, find the file you want to print, or edit and edit it there.
- After editing a file, you can attach it to email or print it out, or save it for future editing.
Note: documents in Portable Document Format (PDF) require Adobe Acrobat Reader 5.0 or higher to view,
download Adobe Acrobat Reader.
Note: documents in Excel format (XLS) require Microsoft Viewer,
Note: documents in Word format (DOC) require Microsoft Viewer,
Note: documents in Powerpoint format (PPT) require Microsoft Viewer,
Note: documents in Quicktime Movie format [MOV] require Apple Quicktime,