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 Student’s
Responsibilities form
_____ Letters of recommendation (3)
_____
_____
_____ 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