Practicum and Internship
Clinical Mental Health Counseling &
Marriage, Couple, and Family Counseling
Practicum (CNS 591) and Internship (CNS 596)
- Practicum and Internship Manual (CMHC & MCFC)
- Approved Practicum & Internship Sites
- Counseling Job Opportunities
Required Clinical Paperwork
Please follow the directions for completing and submitting the form in PDF.
- Practicum Portfolio Checklist
- Internship Portfolio Checklist
- Practicum Application Form
- Practicum Site and Supervision Contract
- Internship Site and Supervision Contract
- Practicum/Internship Hour Log
- Practicum Evaluation of Student Performance (Midterm and Final)
- Practicum Counseling Skills Scale
- Internship Evaluation of Student Performance (Midterm and Final)
- Student Evaluation of Supervisor
- Student Evaluation of Site
- Sample LPCA Application
- Permission to Video
- Plan of Action for Course Completion
- Petition for Change in Practicum or Internship Site
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:
- Site Information Form (form should be saved first and then completed in Adobe Reader or Pro)
- Site Visit Checklist
Related Departmental Policies
- CSA Policy on Security of Media (Video and Audio)
- Practice Preparation Sequence and Departmental Approval for Practicum and Internship Placement Policies
- Internship Grading
Directions for working with the Forms
- Right click on the link above and choose "save as," and save the file to your computer.
- Open the file you want to print or edit and modify if desired. After editing the file, save it.
- Attach it to email, print it, or save it for future editing.
- To view PDFs, you can download Adobe Reader free by going to http://get.adobe.com/reader/.
- To create PDF files, you can download CutePDF for free at http://www.cutepdf.com/.
Dates & Deadlines
2015-2016 Practicum & Internship
- Aug 14, 2015: Submit all final signed paperwork (see Practicum Portfolio Checklist) to your Faculty Supervisor and the Clinical Coordinator. Contact CC if an extension is required.
- Aug 14, 2015: Submit the Internship Site and Supervision Contract.
- Aug 24, 2015: Begin internship.
- Oct 9, 2015: Submit mid-term evaluations to faculty supervisor for review and signature.
- Dec 4, 2015: Submit all final signed paperwork (see Practicum Portfolio Checklist) to your Faculty Supervisor and the Clinical Coordinator. Contact CC if an extension is required. Must be submitted no later than 12/10/15.
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,