Internship Forms & Reports

Marriage & Family Therapist

Primary Six-Month Internship Report (Form #1)

Secondary Six Month Internship Report (Form #2)

MFT Intern Final Internship Report (Form #3)

When submitting an MFT-Intern Final Internship Report: Form 3, also submit along with it a Primary Six Month Internship Report: Form 1 and a Secondary Report: Form 2.).

Clinical Professional Counselors

Primary Six Month Internship Report (Form #4)
Secondary Six Month Internship Report (Form# 5)
CPC-Intern Final Internship Report (Form# 6)

When submitting a CPC-Intern Final Internship Report: Form 6, also submit along with it a Primary Six Month Internship Report: Form 4 and a Secondary Report: Form 5.

Other Forms

Internship Extension Form
Practicum Internship Report from University Supervisor (Form #7)
Supervisor & Intern Dissolution Form

To be submitted with the Application or anytime during the internship

MFT Exam Request Form
CPC Exam Request Form

Supervision Forms

Primary Supervisory Internship Proposal
Secondary Supervision Contract Form
Licensed Mental Health Professional Available for Consultation