Practicum Forms

These forms are specific to the process of the student's practicum experience. To find the required forms for your practicum, click on the applicable track.  For information on how to begin the practicum process, such as how to obtain a practicum site and necessary clearances, etc. click here.

Mental Health Counseling Forms

Marriage, Couple, and Family Counseling Forms

School Counseling Forms

Mental Health Counseling Forms

Student Forms:

The following forms are required of the student throughout the practicum experience.

*Please be sure to view this Due-Date List, so that you are aware of the due dates for each form.

  • Counseling Practicum Checklist for Students—This checklist details all the pre-requisites for students pursuing registration in a counseling practicum. Completion of all parts of this checklist is necessary before students may be registered for (and therefore begin) their practicum.
  • Practicum Pre-Registration Form - Email this completed form to the program's administrative assistant.
  • Mental Health Counseling Practicum Handbook: Students are required to read the practicum handbook before the beginning of their practicum.
  • MMPI Verification Form
  • Checklist for Potential Supervisors - Once you have located an appropriate site and Site Supervisor, complete this form and email it with your supervisor's resume to the program's administrative assistant. Your Site Supervisor must be approved before you can enter into a contract with the site/Site Supervisor. You will be notified when your Site Supervisor has been approved.
  • Practicum Contract—This contract between the student, Site Supervisor, and Practicum and Internship Coordinator represents the agreements of each to appropriately participate in the practicum experience and must be signed and sent to the program's administrative assistant prior to registration.
  • Informed Consent Form —This form must be signed prior to any counseling sessions. (Spanish version available)
  • Counseling Practicum Weekly Summary Log—Students will fill out these logs each week based on their practicum experiences.
  • Counseling Practicum Semester Summary Log—Students will fill out this log at the end of the practicum, acquire their Site Supervisor’s signature, and email it to their faculty supervisor and the program's administrative assistant.
  • Clinical Mental Health Practicum Evaluation Forms - These forms will be completed by the site supervisor and the faculty supervisor at the half-way point and at the conclusion of your practicum experience.  You do not need to initiate the evaluation by providing your supervisors with these forms; a link will be sent to them from our office so they can complete the evaluations electronically.  These forms are posted to make you aware in advance of the criteria being used for your evaluations.  Site Supervisor mid-term; Site supervisor final; Faculty supervisor mid-term; Faculty supervisor final.

Marriage, Couple, and Family Counseling

Student Forms:

The following forms are required of the student throughout the practicum experience.

*Please be sure to view this Due-Date List, so that you are aware of the due dates for each form.

  • Counseling Practicum Checklist for Students—This checklist details all the pre-requisites for students pursuing registration in a counseling practicum. Completion of all parts of this checklist is necessary before students may be registered for (and therefore begin) their practicum.
  • Practicum Pre-Registration FormEmail this completed form to the program's administrative assistant.
  • Marriage, Couple, and Family Counseling Practicum Handbook—Students are required to read the practicum handbook before they begin their practicum experience.
  • MMPI Verification Form
  • Checklist for Potential Supervisors—Once you have located an appropriate site and Site Supervisor, complete this form and email it and your supervisor's resume to the program's administrative assistant. Your Site Supervisor must be approved before you can enter into a contract with the site/Site Supervisor. You will be notified when your Site Supervisor has been approved.
  • Practicum Contract—This contract between the student, Site Supervisor, and Practicum and Internship Coordinator represents the agreements of each to appropriately participate in the practicum experience and must be signed and emailed to the program's administrative assistant prior to registration.
  • Informed Consent Form —This form must be signed prior to any counseling sessions. (Spanish version available)
  • Counseling Practicum Weekly Summary Log—Students will fill out these logs each week based on their practicum experiences.
  • Counseling Practicum Semester Summary Log—Students will fill out this log, acquire their Site Supervisor’s signature, and email it to their Faculty Supervisor and the program's administrative assistant.
  • Marriage Couple Family Practicum Evaluation Forms - These forms will be completed by the site supervisor and the faculty supervisor at the half-way point and at the conclusion of your practicum experience.  You do not need to initiate the evaluation by providing your supervisors with these forms; a link will be sent to them from our office so they can complete the evaluations electronically.  These forms are posted to make you aware in advance of the criteria being used for your evaluations.  Site Supervisor mid-term; Site supervisor final; Faculty supervisor mid-term; Faculty supervisor final.

School Counseling

Student Forms:

The following forms are required of the student throughout the practicum experience.

*Please be sure to view this Due-Date List, so that you are aware of the due dates for each form.

  • Counseling Practicum Checklist for Students—This checklist details all the pre-requisites for students pursuing registration in a counseling practicum. Completion of all parts of this checklist is necessary before students may be registered for (and therefore begin) their practicum.
  • Practicum Pre-Registration Form—Email this completed form to the program's administrative assistant.
  • School Counseling Practicum Handbook - Students are required to read the practicum handbook before they may begin their practicum experience.
  • MMPI Verification Form
  • Checklist for Potential Supervisor—Once you have located an appropriate site and Site Supervisor, complete this form and email it and your supervisor's resume to the program's administrative assistant. Your Site Supervisor must be approved before you can enter into a contract with the site/Site Supervisor. You will be notified when your Site Supervisor has been approved.
  • Practicum Contract—This contract between the student, Site Supervisor, and Practicum and Internship Coordinator represents the agreements of each to appropriately participate in the practicum experience and must be signed and emailed to the program's administrative assistant prior to registration.
  • Recording Consent Form —This form must be completed before any sessions can be recorded. (Spanish version available)
  • Counseling Practicum Weekly Summary Log  - Students will fill out these logs as they accrue the necessary hours and requirements for their practicum.
  • Counseling Practicum Semester Summary Log—Students will fill out this log, acquire their Site Supervisor’s signature, and email it to their Faculty Supervisor and the program's administrative assistant.
  • School Counseling Practicum Evaluation Forms - These forms will be completed by the site supervisor and the faculty supervisor at the half-way point and at the conclusion of your practicum experience.  You do not need to initiate the evaluation by providing your supervisors with these forms; a link will be sent to them from our office so they can complete the evaluations electronically.  These forms are posted to make you aware in advance of the criteria being used for your evaluations.  Site Supervisor mid-term; Site supervisor final; Faculty supervisor mid-term; Faculty supervisor final.