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Western Kentucky University

Counseling and Student Affairs

Practicum and Internship

Clinical Mental Health Counseling &
Marriage, Couple, and Family Counseling
Practicum (CNS 591) and Internship (CNS 596)

Resources

Required Clinical Paperwork

Please follow the directions for completing and submitting the form in PDF.

Additional Paperwork

Establishing and Maintaining Clinical Sites

Review the Practicum & Internship Manual for instructions on establishing a  new site or maintaining a clinical site.  The following are forms used for reviewing and updating sites annually:

Related Departmental Policies

Directions for working with the Forms


  1. Right click on the link above and choose "save as," and save the file to your computer.
  2. Open the file you want to print or edit and modify if desired. After editing the file, save it.
  3. Attach it to email, print it, or save it for future editing.
  4. To view PDFs, you can download Adobe Reader free by going to http://get.adobe.com/reader/.
  5. To create PDF files, you can download CutePDF for free at http://www.cutepdf.com/.

Dates & Deadlines

2014-2015 Internship

  • December 5, 2014  Submit all final signed paperwork (WKU portfolio) to the Clinical Coordinator.
  • January 19, 2015 Submit Spring Internship Contract and updated membership or insurance if expired.
  • February 4, 2015, 4:15-5:00pm  
    You are invited to be on the Intern Panel to share your prac & internship experiences as part of the P&I orientation.
  • February 16, 2015, 3-5pm  Attend the Internship & Job Fair and Site Supervisor Panel to identify future employment opportunities if desired.
  • March 20, 2015 Submit mid-term evaluations to faculty supervisor for review and signature.
  • May 8, 2015  Submit all final signed paperwork (WKU portfolio) to the Clinical Coordinator.

2015-2016 Practicum & Internship

  • February 4, 2015, 3:30-5:00pm  Practicum & Internship Orientation (required for new practicum students).
  • February 16, 2015, 3-5pm  Attend the Internship & Job Fair and Site Supervisor Panel to learn more about potential practicum and internship sites.
  • March 4, 2015  Submit the Practicum Application Form and associated documents to the Clinical Coordinator.
  • March 2015  Review approved Site Information Forms and begin applying to sites of interest once application is approved by the Clinical Coordinator.
  • March 2015  If all requirements have been met, you will be enrolled in the practicum group supervision course (CNS 591) by the Clinical Coordinator
  • April 2015  Finalize practicum site placement and submit the Practicum Site and Supervision Contract.
  • May 18, 2015  Begin practicum

Note: documents in Portable Document Format (PDF) require Adobe Acrobat Reader 5.0 or higher to view,
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Note: documents in Excel format (XLS) require Microsoft Viewer,
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Note: documents in Word format (DOC) require Microsoft Viewer,
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Note: documents in Powerpoint format (PPT) require Microsoft Viewer,
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Note: documents in Quicktime Movie format [MOV] require Apple Quicktime,
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 Last Modified 12/1/14