Internship Forms & Reports

Marriage & Family Therapists

• 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 Renewal Request 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 Testing Request Form

Supervision Forms

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