Forms and Clinic Policies

Applications

• UBC Practicum Planning Agreement (a.k.a. Blue Form)
• UBC Internship Approval (a.k.a. Yellow Form)
• UBC Internal Practicum Approval

Practicum Guidelines for Supervisors

• Practicum Guidelines

Practicum Contract

• Template
• Sample 1
• Sample 2
• Sample 3

Evaluations

• Student Evaluation
• Supervisor Evaluation

Handbooks and Guidelines

• Practicum and Internship Handbook
• Clinic Assistant Procedures Manual
• Clinic Policies and Procedures Manual for Graduate Student Therapists
• CCPPP Guidlelines for the Documentation of Professional Psychology Training Hours

Documentation

• Adult Phone Screen (UBC Psychology Clinic)
• Neuropsychological Assessment Phone Screen(UBC Psychology Clinic)
• Child Telephone Screen (UBC Psychology Clinic)
• Consent Form for Face-to-Face and Online Services (UBC Psychology Clinic)
• Consent to Release and Receive Information (UBC Psychology Clinic)
• Clinic Adult Intake Assessment Form – Revised 2024  (UBC Psychology Clinic)
• Sample Assessment Report (UBC Psychology Clinic)
• Progress Note Template (UBC Psychology Clinic)
• Termination Summary for Archive (UBC Psychology Clinic)
• Sample Termination Report (UBC Psychology Clinic)
• File Audit Form (UBC Psychology Clinic)
• COVID Consent (UBC Psychology Clinic)

Supervision Resources

• Supervision Note
• Sample Supervision Philosophy Statement
• Leeds Alliance in Supervision Scale
  • Unpublished dissertation (Nigel Wainwright, 2010)

Clinic Library

• • Clinic Library Policy
  • Clinic Library Holdings
  • Clinic Assessment Materials