School Psychology Practicum Hours Log School Psychology Practicum Hours Log 12 General InformationStudent Name First Last Student Email Enter Email Confirm Email Supervisr Name First Last Supervisor Email Enter Email Confirm Email SiteWeekThis field is hidden when viewing the formHidden EntryEntryBeginning Date of Week MM slash DD slash YYYY End Date of Week MM slash DD slash YYYY Assessment ActivityFile Review HoursRunning TotalRunning %Observation: Preschool (3.0-5.11)HoursRunning TotalRunning %Observation: Elementary (6.0-12.6)HoursRunning TotalRunning %Observation: Middle (12.6-14.6)HoursRunning TotalRunning %Observation: High (14.7 and above)HoursRunning TotalRunning %Diagnostic Interview: Parent(s)HoursRunning TotalRunning %Diagnostic Interview: StudentHoursRunning TotalRunning %Diagnostic Interview: TeacherHoursRunning TotalRunning %Diagnostic Interview: Other Professional(s)HoursRunning TotalRunning %Norm-Referenced Assessment: Preschool (3.0-5.11)HoursRunning TotalRunning %Norm-Referenced Assessment: Elementary (6.0-12.6)HoursRunning TotalRunning %Norm-Referenced Assessment: Middle (12.7-14.6)HoursRunning TotalRunning %Norm-Referenced Assessment: High (14.7 and above)HoursRunning TotalRunning %Alternative Assessments: ScreeningHoursRunning TotalRunning %Alternative Assessments: Curriculum-Based MeasurementHoursRunning TotalRunning %Alternative Assessments: Progress Monitoring HoursRunning TotalRunning %Alternative Assessments: Criterion-ReferencedHoursRunning TotalRunning %Scoring and Report WritingHoursRunning TotalRunning %Miscellaneous, OtherHoursRunning TotalRunning %HoursHours this WeekRunning Total SectionRunning % SectionDirect InterventionsIndividual CounselingHoursRunning TotalRunning %Group CounselingHoursRunning TotalRunning %Class-Wide Social Emotional ServiceHoursRunning TotalRunning %Functional Behavioral AssessmentsHoursRunning TotalRunning %Behavior Support Plan/Behavior Intervention Plan Development/ InterventionHoursRunning TotalRunning %Academic Support Plan Development/ ImplementationHoursRunning TotalRunning %Other Intervention Implementation/ MeasurementHoursRunning TotalRunning %Crisis InterventionHoursRunning TotalRunning %Miscellaneous, OtherHoursRunning TotalRunning %HoursHours this WeekRunning Total SectionRunning % Section Consultation and CollaborationIndirect InterventionsPre-referral/Support Team MeetingRegular EdHoursRunning TotalRunning %Multidisciplinary Team Meeting Special EdHoursRunning TotalRunning %IEP/Evaluation Team MeetingHoursRunning TotalRunning %Parent/FamilyHoursRunning TotalRunning %School PersonnelHoursRunning TotalRunning %Other ProfessionalHoursRunning TotalRunning %Miscellaneous, OtherHoursRunning TotalRunning %HoursHours this WeekRunning Total SectionRunning % SectionProgram Evaluation and ResearchChild Study/Evaluation PlanningHoursRunning TotalRunning %Formative Evaluation of Individual Student DataHoursRunning TotalRunning %Formative Evaluation of Groups in SchoolHoursRunning TotalRunning %Formative Evaluation of School-Wide DataHoursRunning TotalRunning %Formative Evaluation of District-Wide DataHoursRunning TotalRunning %ResearchHoursRunning TotalRunning %Miscellaneous, OtherHoursRunning TotalRunning %HoursHours this WeekRunning Total SectionRunning % SectionProfessional Growth and DevelopmentOrientations (School Setting and Organization, Programs and Community Service) HoursRunning TotalRunning %School Staff Workshop/In-Service (Giving)HoursRunning TotalRunning %School Staff Workshop/In-Service (Attending)HoursRunning TotalRunning %Psychologist Training/ Professional DevelopmentHoursRunning TotalRunning %Direct University SupervisionHoursRunning TotalRunning %Miscellaneous, OtherHoursRunning TotalRunning %HoursHours this WeekRunning Total SectionRunning % SectionSupervisionMust be at least one hour per week on average. SupervisionFieldHoursRunning TotalMiscellaneous/OtherOrganizational TimeHoursRunning TotalRunning %TravelHoursRunning TotalRunning %HoursHours this WeekRunning Total SectionRunning % SectionTotal Hours for InternshipCombinedThis field is hidden when viewing the formHidden FieldsThis field is hidden when viewing the formHidden File ReviewThis field is hidden when viewing the formHidden Observation: PreschoolThis field is hidden when viewing the formHidden Observation: ElementaryThis field is hidden when viewing the formHidden Observation: MiddleThis field is hidden when viewing the formHidden Observation: HighThis field is hidden when viewing the formHidden Diagnostic Interview: ParentsThis field is hidden when viewing the formHidden Diagnostic Interview: StudentThis field is hidden when viewing the formHidden Diagnostic Interview: TeacherThis field is hidden when viewing the formHidden Diagnostic Interview: Other ProfessionalsThis field is hidden when viewing the formHidden Norm-Referenced Assessment: PreschoolThis field is hidden when viewing the formHidden Norm-Referenced Assessment: ElementaryThis field is hidden when viewing the formHidden Norm-Referenced Assessment: MiddleThis field is hidden when viewing the formHidden Norm-Referenced Assessment: HighThis field is hidden when viewing the formHidden Alternative Assessments: ScreeningsThis field is hidden when viewing the formHidden Alternative Assessments: Curriculum-Based MeasurementThis field is hidden when viewing the formHidden Alternative Assessments: Progress MonitoringThis field is hidden when viewing the formHidden Alternative Assessments: Criterion-ReferencedThis field is hidden when viewing the formHidden Scoring and Report WritingThis field is hidden when viewing the formHidden Miscellaneous, Other Assessment ActivityThis field is hidden when viewing the formHidden Individual CounselingThis field is hidden when viewing the formHidden Group CounselingThis field is hidden when viewing the formHidden Class-Wide Social Emotional ServicesThis field is hidden when viewing the formHidden Functional Behavioral AssessmentsThis field is hidden when viewing the formHidden Behavior Support Plan/Behavior Intervention Plan Development/ImplementationThis field is hidden when viewing the formHidden Academic Support Plan Development/ImplementationThis field is hidden when viewing the formHidden Other Intervention Implementation/MeasurementThis field is hidden when viewing the formHidden Crisis InterventionThis field is hidden when viewing the formHidden Miscellaneous, Other Direct InterventionsThis field is hidden when viewing the formHidden Pre-Refferal/Support Team Meeting (Regular Ed)This field is hidden when viewing the formHidden Multidisciplinary Team Meeting (Special Ed)This field is hidden when viewing the formHidden IEP/Evaluation Team MeetingThis field is hidden when viewing the formHidden Parent/FamilyThis field is hidden when viewing the formHidden School PersonnelThis field is hidden when viewing the formHidden Other ProfessionalThis field is hidden when viewing the formHidden Miscellaneous, Other Consultation and CollaborationThis field is hidden when viewing the formHidden Child Study/Evaluation PlanningThis field is hidden when viewing the formHidden Formative Evaluation of Individual Student DataThis field is hidden when viewing the formHidden Formative Evaluation of Groups in SchoolThis field is hidden when viewing the formHidden Formative Evaluation School-Wide DataThis field is hidden when viewing the formHidden Formative Evaluation District-Wide DataThis field is hidden when viewing the formHidden ResearchThis field is hidden when viewing the formHidden Miscellaneous, Other Program Evaluation and ResearchThis field is hidden when viewing the formHidden OrientationsThis field is hidden when viewing the formHidden School Staff Workshop/In-Service (Giving)This field is hidden when viewing the formHidden School Staff Workshop/In-Service (Attending)This field is hidden when viewing the formHidden Psychologist Training/Professional MeetingsThis field is hidden when viewing the formHidden Direct University SupervisionThis field is hidden when viewing the formHidden Miscellaneous, Other Professional Growth and DevelopmentThis field is hidden when viewing the formHidden SupervisionThis field is hidden when viewing the formHidden Organizational TimeThis field is hidden when viewing the formHidden TravelThis field is hidden when viewing the formHidden Assessment Activity for WeekThis field is hidden when viewing the formHidden Direct Interventions for WeekThis field is hidden when viewing the formHidden Consultation and Collaboration for WeekThis field is hidden when viewing the formHidden Program Evaluation and Research for WeekThis field is hidden when viewing the formHidden Professional Growth and Development for WeekThis field is hidden when viewing the formHidden Miscellaneous/Other for Week Δ