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Evaluation type
Mid-Placement Evaluation
Final Evaluation
I am the...
Student
Supervisor
Student first and last name
Placement Site
Supervisor first and last name
Dates of Practicum
Student's Practicum Instructor
Supervisors, ask your student which section they are in
Section A (Pamela Loughton)
Section B (Ara Parker)
Section C (Kristine Lund)
Number of Counselling Hours
Number of Counselling Hours
Individual
Child/Adolescent
Couple
Family
Group
Total
Number of Supervision Hours
Number of Supervision Hours
Individual/Dyadic
Group (no more than 8 members)
Total
Nature of Practicum Experience
Description of counselling setting, kinds of clients seen, methods of observation by supervisor
0%
Current Progress 0%
100%
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