AGREEMENT BETWEEN THE4-Way Agreement • November 3rd, 2022
To the MFT Trainee: First, read, initial, and sign this document. Then, take it to the director of your clinical site and to your Clinical Supervisor to read and sign. After all three have signed the contract, your practicum/fieldwork instructor will sign your contract. Be sure to make and distribute photocopies to the Agency Director, Clinical Supervisor, and your instructor. You should keep the original form. The completed "4-Way Agreement" must be on file before supervised clinical hours begin in order for the hours to count towards practicum/fieldwork hours. The Clinical Training Faculty are:
MARITAL AND FAMILY THERAPY PROGRAM4-Way Agreement • February 11th, 2019
This document must be completed and on file in the Clinical Training Coordinator’s (FIELDWORK COORDINATOR) office before the Trainee’s hours may count towards MFT licensure! California State University, Dominguez Hills (CSUDH) has no authority to approve hours. CSUDH is only responsible for coordinating students’ clinical experience and approving sites. Thus, we do our best to find sites whose clientele and methods of practice fall within the scope of the MFT license. Under penalty of perjury supervisors attest that they are legally suitable to supervise MFT Trainees and that they will insure that their Trainees practice within the law. We approve sites and supervisors based upon the information provided to us by the site and supervisor. CSUDH assumes no responsibility for the loss of hours caused by misstatements, incorrect information and/or negligence on the part of a supervisor and/or agency director. Approval of hours is, and always has been, the purview of the Board of Behavioral
Agreement between the4-Way Agreement • October 10th, 2017 • California
This document must be completed and on file in the Program Administrator’s office before the supervisee’s hours may count toward BCBA experience hours! Pepperdine has no authority to approve hours. Pepperdine is only responsible for coordinating students’ clinical experience. Thus, we do our best to find sites whose clientele and methods of practice fall within the scope of the BCBA certification. Under penalty of perjury supervisors attest that they are legally suitable to supervise BCBA supervisees and that they will ensure that their supervisees practice within the law. Pepperdine assumes no responsibility for the loss of hours caused by misstatements, incorrect information and/or negligence on the part of a supervisor and/or agency director. Approval of hours is, and always has been, the purview of the Behavior Analyst Certification Board (BACB®).
