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Supervisor Information and Forms

Message from Clinical Director

Externship Packet (pdf)

Proof of Insurance (pdf)

Timeline (pdf)

Clinical Supervision Regulations
How much time to spend supervising student clinician.

Individual Forms

• Externship Signature Card
• Off-campus Clinical Practicum Agreement
• Externship Supervisor/Clinician Conference
• Clinician Attendance Record
  Clinician Attendance Record Sample
• Practicum Evaluation (Excel spreadsheet)
  Practicum Evaluation Sample
  Supervision Rating Scale (to be used with practicum evaluation form)
• Diagnostic Session Evaluation (Word document)
• Therapy Session Evaluation (Word document)
• Written Communication Evaluation (Word document)