This customizable form outlines the specific requirements for passing each internship course. By endorsing the form, students are acknowledging their understanding of and agreements with the passing minimums for the course.

The CACREP 2016 definition of “Direct Service” is: supervised use of counseling, consultation, or related professional skills with actual clients (can be individuals, couples, families, or groups) for the purpose of fostering social, cognitive, behavioral, and/or affective change. These activities must involve interaction with others and may include: (1) assessment, (2) counseling, (3) psycho-educational activities, and (4) consultation. The following would not be considered direct service: (1) observing others providing counseling or related services, (2) record keeping, (3) administrative duties, (4) clinical and/or administrative supervision.

 The requirements and definition of “Direct Service” on this form should be edited for your institution.