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Practicum/Internship Application and Agreement

Copies of this page will be sent to the email address you have provided, the Practicum/Internship students  EKU email address and to the EKU Department of Counseling office to maintain records. If you have any questions about the use or intent of these forms please contact EKU’s Counseling department at 859.622.1124.      J-TERM Application and Agreement found here

Under the University supervision of the faculty member who is the Instructor of Record for the course section in which the student is enrolled. Direct contact information will be provide via the course syllabus and shared with the site. Prior to beginning the course, please direct any communication to the Clinical Experiences Coordinator.

It is mutually agreed that the above named agency or school will provide the following services and supervision:  

  • An orientation to the agency or school, including policies and procedures relevant to the student’s position, and a definition of clearly articulated student duties.
  • Weekly supervision of one (1) hour provided by a certified school counselor for practicum and internship students in school counseling and, for mental health counseling students, by an individual with a master’s degree in a mental health area with appropriate licensure and/or certification, and two (2) years of post master’s degree counseling experience. All missed supervision sessions will be rescheduled.
  • Site supervisor will regularly review recorded sessions of student’s counseling sessions.
  • Site supervisor will agree to participate in the EKU CEP Site Supervisor Training.
  • Supervision will adhere to guidelines established by the site and to the guidelines for supervision noted in the American Counseling Association’s current Code of Ethics available on-line at
  • Site supervisor will complete all required paperwork for practicum or internship including a mid-semester and end of semester evaluation of the student’s performance and the review of the supervisee’s log sheets.
  • Site supervisor will contact the faculty of record immediately upon the knowledge of any concerns, problems, or ethical violations in relation to duties performed by the student while completing his or her responsibilities associated with the practicum or internship. 

That the student will:

  • Be at the agreed upon site on the following days and times: 
  • Be assigned the following specific duties and responsibilities:
  • Attend all sessions of group supervision meetings at EKU as part of either COU 880 or COU 881.
  • Keep a complete and current log of all time spent at site to be reviewed and signed by the site supervisor weekly.
  • Adhere to ACA ethical standards of practice at all times.
  • Immediately inform the faculty of record if there are any concerns or problems regarding the site.

That the Dept. of Counseling and Educational Psychology at Eastern Kentucky will:

  • Inform the student regarding all requirements involved in the Practicum and Internship via a course syllabus and the Practicum and Internship Handbook.
  • Provide group supervision via the regularly scheduled meetings of COU 880 or COU 881 and individual and/or triadic supervision for students participating in COU 880, and additionally as needed.
  • Maintain periodic contact with the site supervisor to discuss the student’s progress including on-site visits, phone contact and/or email by the student’s university supervisor as needed.
  • Maintain appropriate records for registration and grading. It is the expectation of all three parties involved that the above conditions be met. Should it become apparent that they are not being met by any of the given parties, it is imperative that all three parties discuss the situation immediately.

Taskstream: This class requires a subscription to Taskstream ( for completion of the Key Assessment. For more information about setting up your account or re-subscribing to Taskstream, please visit‚Äč

All students are required to abide by the standards of conduct established by Eastern Kentucky University. Follow the link below and review all mandatory expectations:

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