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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)
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
Week 2
* "Other" Direct Service:
** "Other" Non-Direct Service:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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