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Practicum Paperwork Checklist

Alcohol and Substance Abuse Counseling

 

To assist you with the successful completion of this packet, mark off the required documents as you complete them.

 

Before Practicum begins, complete the following and submit to the course Instructor:

 

_____†††††††††††† Application

 

_____†††††††††††† Practicum Studentís Responsibilities form

 

_____†††††††††††† Letters of recommendation (3)

 

_____

 

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_____†††††††††††† Learning Contract

 

_____†††††††††††† Release form with SITE SUPERVISOR

 

_____†††††††††††† Release form with COURSE INSTRUCTOR

 

_____†††††††††††† Code of Ethics

 

At the completion of 100 hours of Practicum complete the following and submit to the course Instructor:

 

_____†††††††††††† Mid-term Evaluation

 

_____†††††††††††† Twelve Core Function Summary Sheet

 

At the completion of all 200 hours of Practicum complete the following and submit to the course Instructor:

 

_____†††††††††††† Student Site Evaluation

 

_____†††††††††††† Supervisor Final Evaluation

 

_____†††††††††††† Summary paper of experience

 

_____†††††††††††† Copy of Log Book