Department of Counseling and Special Education

School Weekly Practicum Log

School Counseling Weekly Practicum Log

Name:

Site: Supervisor:

Beginning Date: Ending Date:

Activity Monday Tuesday Wednes-

day Thursday Friday Saturday Sunday Total Hours

Direct Hours

Individual Counseling

Group Counseling

Group Guidance

Career Guidance

Assessment Interviews

Parent Meeting/

Conferences

Substance Abuse

Intervention

Crisis Intervention

MFE/IEP with

Student/Parent

Consultation

Direct Hours Total:

Indirect Hours Conferences & Workshops

Develop Program Materials

Reviewing Audio/ Video

Tapes

Contact with

Agencies/Colleges

Faculty/Staff Meetings

Test Admin. &

Coordination

In-Service

Record Keeping

Individual Supervision

Group Supervision

(in class supervision)

Observation of Students

Scheduling Activities

Making Referrals

Other (specify)

Indirect Hours Total:

All Hours Total:

Intern Signature: Date:

Site Supervisor Signature: Date:

Faculty Instructor Signature: Date: