Appendix B - Forms & Information

 

Download the complete Appendix BPDF File Opens in new window

  1. DeclarationPDF File Opens in new window
  2. Consent Form for Participation in Counseling PracticumPDF File Opens in new window
  3. Transportation Storage of Confidential Client DataPDF File Opens in new window
  4. 4-Way AgreementPDF File Opens in new window
  5. CHHD In-person Internship Practicum Clinical Sites COVID19 AgreementPDF File Opens in new window
  6. CHHD In-person Internship Practicum Clinical Sites COVID19 Agreement_SAMPLEPDF File Opens in new window
  7. In-Person Internship Student AcknowledgementPDF File Opens in new window
  8. In-Person Internship Student Release of LiabilityPDF File Opens in new window
  9. In-Person Internship Student Release of Liability_SAMPLEPDF File Opens in new window
  10. BBS Supervision AgreementPDF File Opens in new window
  11. BBS Weekly Summary of Hours of ExperiencePDF File Opens in new window
  12. BBS MFT Experience VerificationPDF File Opens in new window
  13. BBS MFT Sample Letter of Agreement – Volunteer SupervisionPDF File Opens in new window
  14. Beginning Practicum Summary Log/Semester Accounting FormPDF File Opens in new window
  15. Advanced Practicum Summary Log/Semester Accounting FormPDF File Opens in new window
  16. Site Supervisor Mid-semester Evaluation of StudentPDF File Opens in new window
  17. Counseling 530: Beginning Practicum - Practicum Presentations Evaluation RubricPDF File Opens in new window
  18. Counseling 584, 590 & 591: Advanced Practicum- Practicum Presentations Evaluation RubricPDF File Opens in new window
  19. Counseling 511, 530 & 584: Professor Evaluation of Counselor Student/Trainee Dispositions & ProfessionalismPDF File Opens in new window
  20. Counseling 511: Professor Evaluation of Counseling Student Clinical Skills in COUN 511PDF File Opens in new window
  21. Counseling 530: Professor Evaluation of Counselor Practicum Trainee Clinical Skills; Case Conceptualization & Treatment Planning; DiversityPDF File Opens in new window
  22. Counseling 584, 590 & 591: Professor Evaluation of Counselor Practicum Trainee Clinical Skills; Case Conceptualization & Treatment Planning; DiversityPDF File Opens in new window
  23. Site Supervisor Final Evaluation of PCC/MFT TraineePDF File Opens in new window
  24. Student Assessment of Clinical Training SitePDF File Opens in new window
  25. Student Evaluation of Site SupervisorPDF File Opens in new window
  26. End of Semester Check-OutPDF File Opens in new window
  27. COUN 530 e-FormPDF File Opens in new window
  28. Sample ResumePDF File Opens in new window
  29. Quick NotesPDF File Opens in new window