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EIU Master of Science in Counseling

Internship and Practicum Information

Supervision Training Video

Clinical Counseling

  • A list of available Practicum and Internship sites.

  • Click here for more information about Clinical Mental Health Counseling Practicum and Internship.

  • Click here for information on individual professional liability insurance - REQUIRED beginning FALL 2020

  • Practicum and Internship Manual for Clinical Mental Health Counseling

  • If you are planning on doing your practicum or internship at a government agency, you will be required to partake in a mandatory training session designed to familiarize you with the Illinois Medicaid Comprehensive Assessment (IM+CANS). Please complete this training before you start at your site. You may reach out to your site in order to get costs covered for training. Training Schedule. 

Clinical Counseling Forms

Word

PDF

Supervisee Evaluation of Site

Click Here

Click Here

Supervisee Evaluation of Site Supervisor

Click Here

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Site Supervisor’s Evaluation of Clinical Practicum Supervisee

Click Here

Click Here

Site Supervisor’s Evaluation of Internship Supervisee

Click Here

Click Here

Internship Supervisor Survey (3rd Semester Internships ONLY)

Click Here

Click Here

Practicum Activity Log -USE forms provided in Practicum/Internship meeting in FALL (Purple packets)

 

 

Internship Activity Log - USE color coded card stock FORMS (Blue-Fall, Pink-Spring, Yellow-Summer)

 

 

Release for Videotaping

Click Here

Click Here

Application for Practicum

 

Click Here

Clinical Practicum Agreement - SAMPLE ONLY - DO NOT USE

 

Click Here

Application for Internship

 

Click Here

Clinical Internship Agreement - SAMPLE ONLY - DO NOT USE

 

Click Here

Group Consent Form

Click Here

Click Here

Clinical Change of Supervisor

 

Click Here

Clinical Additional Supervisor

 

Click Here

School Counseling

School Counseling Forms

Word

PDF

Supervisee Evaluation of Site

Click Here

Click Here

Supervisee Evaluation of Site Supervisor

Click Here

Click Here

Site Supervisor’s Evaluation of School Practicum Supervisee

Click Here

Click Here

Site Supervisor’s Evaluation of Internship Supervisee

Click Here

Click Here

Internship Supervisor Survey (3rd Semester Internship ONLY)

Click Here

Click Here

Practicum Activity Log -USE forms provided in Practicum/Internship meeting in FALL (Purple packets)

 

 

Internship Activity Log - USE color coded card stock FORMS (Blue-Fall, Pink-Spring, Yellow-Summer)

 

 

Release for Videotaping

Click Here

Click Here

Group Consent Form

Click Here

Click Here

Application for Practicum

 

Click Here

School Practicum Agreement - SAMPLE ONLY - DO NOT USE

 

Click Here

Application for Internship

 

Click Here

School Internship Agreement - SAMPLE ONLY DO NOT USE

 

Click Here

Individual Consent Form

Click Here

Click Here

School Change of Supervisor

 

Click Here

School Additional Supervisor

 

Click Here

Related Pages

Contact Information

Counseling and Higher Education

Eastern Illinois University
600 Lincoln Avenue
Charleston, IL 61920
(217) 581-2400
che@eiu.edu


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