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)
- MFT Responsibility Statement for Supervisors Required in California
- PPC Responsibility Statement for Supervisors Required in California
Personal Therapy
- Personal Therapy Documentation Form (Print Version)
- Personal Therapy Documentation Form (Savable Auto Add Version)
Log Directions and Tools
Practicum Logs
- Sample of PGI Weekly Summary of Hours of Experience
- PGI Weekly Summary of Hours of Experience – New Streamlined Method (Print Version)
- PGI Weekly Summary of Hours of Experience – New Streamlined Method (Savable Auto Add Version)
- Pre-2017 Quarterly Practicum Log (Print Version)
- Pre-2017 Quarterly Practicum Log (Savable Auto Add Version)
- Tania’s Tips For Practicum-Logs
Evaluations
- Quarterly Supervisor’s Evaluation Form (Print Version)
- Quarterly Supervisor’s Evaluation Savable PDF Form (Savable Version)
(this form may only be filled out electronically, please do not print until after completing the form) - Student Evaluation of Supervised Practicum Form Site (Print Version)
- Student Evaluation of Supervised Practicum Site Saveable PDF Form (Savable Version)
(this form may only be filled out electronically, please do not print until after completing the form)
Notification of New Supervisor and/or Supervisor Termination Forms
- Notification of New Supervisor Form
- New Supervisor Affiliation Agreement Pages 3 and 6 required
- LMFT Responsibility Statement for Supervisors Required in California
