Common use of Clinical Mental Health Counseling Clause in Contracts

Clinical Mental Health Counseling. Fill in the blanks of the contract that explicitly describes the agreement between you the student, the supervisor, and the site, including: • Student’s name, address, and telephone number • The name, address and telephone number of the site • The clinical supervisor’s name and credentials • The contact person for the site, if different from the supervisor • The time commitment per week/per semester by the student • The supervision commitment by the supervisor On-Site Fieldwork Contract STUDENT Name: Address: Home Phone: Work Phone: SITE Name: Address: Phone Number: Contact Person:

Clinical Mental Health Counseling. Fill in the blanks of the contract that explicitly describes the agreement between you the student, the supervisor, and the site, including: • Student’s name, address, and telephone number • The name, address and telephone number of the site • The clinical supervisor’s name and credentials • The contact person for the site, if different from the supervisor • The time commitment per week/per semester by the student • The supervision commitment by the supervisor OnOff-Site Fieldwork Contract STUDENT Name: Address: Home Phone: Work Phone: SITE Name: Address: Phone Number: Contact Person:

Clinical Mental Health Counseling. Fill in the blanks of the Draw up a typed contract that explicitly describes the agreement between you the student, the supervisor, and the site, including: • Student’s name, address, and telephone number • The name, address and telephone number of the site • The clinical supervisor’s name and credentials • The contact person for the site, if different from the supervisor • The time commitment per week/per semester by the student • The supervision commitment by the supervisor OnOff-Site Fieldwork Contract STUDENT Name: Address: Home Phone: Work Phone: SITE Name: Address: Phone Number: Contact Person:

Clinical Mental Health Counseling. Fill in the blanks of the Draw up a typed contract that explicitly describes the agreement between you the student, the supervisor, and the site, including: • Student’s name, address, and telephone number • The name, address and telephone number of the site • The clinical supervisor’s name and credentials • The contact person for the site, if different from the supervisor • The time commitment per week/per semester by the student • The supervision commitment by the supervisor On-Site Fieldwork Contract STUDENT Name: Address: Home Phone: Work Phone: SITE Name: Address: Phone Number: Contact Person: