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  • Practicum Bi-Weekly Progress Check-in


    Student First Name:

    Student Last Name:

    Student E-mail:

    Supervisor First Name:

    Supervisor Last Name:

    Supervisor E-mail:

    Supervision Type (Check all that apply):

    Individual Group

    Supervision Modalities (Check all that apply):

    Audio Tape Video Tape
    Direct Observation Case Review

    Client Session (Check all that apply):

    Couples Families Individuals Groups

    Case Issues Discussed:


    Counselor Trainee's Concerns Discussed:


    New Goals for Student Identified:


    Other Input Regarding Student Performance:


Date: 11/29/2015

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