Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0...
Transcript of Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0...
![Page 1: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/1.jpg)
Week 1
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
**Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
* "Other" Direct Service:
** "Other" Non-Direct Service:
KENT STATE UNIVERSITY
WEEKLY INTERNSHIP LOG
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
Directions: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
Direct Hours
Activity Total Week Total to Date
Name: _____________________________________ Week of:________________________ (month/day/year)
![Page 2: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/2.jpg)
Week 2
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours:
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOG
Direct Hours:
Directions: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
Total Week Total to DateActivity
![Page 3: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/3.jpg)
Week 2
* "Other" Direct Service:
** "Other" Non-Direct Service:
![Page 4: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/4.jpg)
Week 3
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours:
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 5: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/5.jpg)
Week 4
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 6: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/6.jpg)
Week 5
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 7: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/7.jpg)
Week 6
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 8: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/8.jpg)
Week 7
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 9: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/9.jpg)
Week 8
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 10: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/10.jpg)
Week 9
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 11: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/11.jpg)
Week 10
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 12: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/12.jpg)
Week 11
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 13: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/13.jpg)
Week 12
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 14: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/14.jpg)
Week 13
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 15: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/15.jpg)
Week 14
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 16: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/16.jpg)
Week 15
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 17: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/17.jpg)
Week 16
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 18: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/18.jpg)
Week 17
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 19: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/19.jpg)
Week 18
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 20: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/20.jpg)
Week 19
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 21: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/21.jpg)
Week 20
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 22: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/22.jpg)
Week 21
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 23: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/23.jpg)
Week 22
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 24: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/24.jpg)
Week 23
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 25: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/25.jpg)
Week 24
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 26: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/26.jpg)
Week 25
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 27: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/27.jpg)
Week 26
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 28: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/28.jpg)
Week 27
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 29: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/29.jpg)
Week 28
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 30: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/30.jpg)
Week 29
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 31: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/31.jpg)
Week 30
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 32: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/32.jpg)
Week 31
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 33: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/33.jpg)
Week 32
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 34: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/34.jpg)
Week 33
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 35: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/35.jpg)
Week 34
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 36: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/36.jpg)
Week 35
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 37: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/37.jpg)
Week 36
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 38: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/38.jpg)
Week 37
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 39: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/39.jpg)
Week 38
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 40: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/40.jpg)
Week 39
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 41: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/41.jpg)
Week 40
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 42: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/42.jpg)
Week 41
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 43: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/43.jpg)
Week 42
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 44: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/44.jpg)
Week 43
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 45: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/45.jpg)
Week 44
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 46: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/46.jpg)
Week 45
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 47: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/47.jpg)
Week 46
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 48: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/48.jpg)
Week 47
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 49: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/49.jpg)
Week 48
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 50: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/50.jpg)
Week 49
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 51: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/51.jpg)
Week 50
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 52: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/52.jpg)
Week 51
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.
![Page 53: Week 1 - du1ux2871uqvu.cloudfront.net · Week 1 Internship Site: _____ Individual counseling 0 Group counseling 0 Couple/family counseling 0 Providing supervision 0 Intakes 0 Crisis](https://reader036.fdocuments.us/reader036/viewer/2022071211/6022571ae5d21a3ff95079b9/html5/thumbnails/53.jpg)
Week 52
Name: _____________________________________ Week of:________________________ (month/day/year)
Internship Site: __________________________________________________________________
Individual counseling 0
Group counseling 0
Couple/family counseling 0
Providing supervision 0
Intakes 0
Crisis consultation 0
Administration of psychological tests 0
Parental Consultation 0
*Other (describe below) 0
Total Direct Hours 0 0
Indirect Hours: 0
Documentation 0
System consultation 0
Teaching 0
Co-teaching 0
Professional development (e.g., staff trainings) 0
Professional conference 0
Research - client services 0
Research - projects 0
Classroom observations 0
Agency/school meetings 0
IEP meetings 0
Receiving supervision - CLINICAL 0
Receiving supervision - all other (e.g., teaching) 0
Internship class 0
*Other (describe below) 0
Total Indirect Hours 0 0
GRAND TOTALS 0 0
Site Supervisor's Signature: ________________________________________ Date __________________
Activity Total Week Total to Date
Direct Hours:
KENT STATE UNIVERSITY
COUNSELOR EDUCATION & SUPERVISION PROGRAM
CES 88292 Internship in Counselor Education & Supervision
WEEKLY INTERNSHIP LOGDirections: This log should be completed weekly and turned in to the internship instructor to be placed in the student's internship file.