Practicum Forms: Masters in Counseling Psychology
Site Approval Forms
- Site Approval Packet for students who began their degree program AFTER 8/1/12 (Current 1st Year Students)
- Responsibility Statement for Supervisors Required in California
Personal Therapy
Logs Log Directions and Tools
Practicum Logs
Evaluations
- Quarterly Supervisor’s Evaluation
- Electronic Quarterly Supervisor’s Evaluation PDF Form this form may only be filled out electronically, please do not print until after completing the form.
- Student Evaluation of Supervised Practicum Site
Notification of New Supervisor and/or Supervisor Termination Forms
- Notification of New Supervisor Form
- New Supervisor Affiliation Agreement Pages 3 and 6 required
- Responsibility Statement for Supervisors Required in California
Site Termination Forms
File Closure Forms (Note: Closing your file means you can no longer accrue hours until after your degree posts)
Miscellaneous Practicum Forms
- Off Site Supervisor Agreement
- Notification of Affiliation Agreement Date Extension
- BBS Experience Verification Form (for hours after 1-1-10) Required in California for licensure
