Clinical Fieldwork Forms
See below for necessary clinical fieldwork forms for University of Memphis master's and doctoral counseling programs. If something below is not working, please e-mail Dr. Claire Dempsey.
Application Dates/Deadlines for Practicum and Internship Intent Forms (for Master's and Doctoral Students)
(NOTE: These are dates that your intent to take Practicium/Internship form is due. You do not have to have your site solidified at this point. Prior to starting your site, you must attend P/I orientation through our program and submit additional paperwork.)
- Spring Practicum/Internship: September 15
- Summer Internship (Clinical Mental Health and Clinical Rehab): February 15
- Fall Practicum/Internship: February 15
Dates/Deadlines to Have Site Solidified for Practicum and Internship
(NOTE: You must have a site solidified by the dates listed below. If you do not, you will not be able to take practicum/internship that semester. Prior to starting your site, you must attend P/I orientation through our program and submit additional paperwork.)
- Spring: December 15
- Summer: May 15
- Fall: July 31
Applications for Practicum and Internship, the P/I Manual, and Site List
- Intent to take Clinical Mental Health Counseling Practicum and Internship
- Intent to take School Counselig Practicum or Internship
- Intent to take Clinical Rehabilitation Practicum or Internship
- Intent to take Doctoral Practicum
- Intent to take Doctoral Internship
- Site Placement Resource List
- Practicum and Internship Manual
Forms Needed During Practicum and Internship
- Practicum and Internship Agreement Samples
- Counseling Sessions Consent and Tape Form
- Carkhuff Live Supervision Ratings Sheet
- Case Conceptualization Sample Form
- School Counseling Program Forms
- Evaluation Forms
Additional Information/Resources for All Counseling Students
- Counseling Program Graduate Student Handbook
- Advice for Practicum Students
- 2014 ACA Code of Ethics
- 2023 NBCC Code of Ethics
- 2024 CACREP Standards
- Counseling Comprehensive Exams Application
- Office of the Registrar: Registration Errors and Problems
- Portfolio:
Additional Information for Doctoral Students
- How to Succeed at Practicum
- Doctoral Program Portfolio Product and Criteria Worksheet
- Doctoral Practicum Clinical Agreement Sample
- Doctoral Supervisor Evaluation
- Doctoral Internship Evaluation (Non-Clinical Counseling and Administrative/Leadership)
- Doctoral Log
- Doctoral Research Internship Evaluation
- Doctoral Teaching Internship Evaluation
- Practicum Internship Reporting Form
- Program Evauation in Doctoral Level Counselor Education Preparation