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MFT Student and Client Forms

Student Forms


Forms for work in PICFTC: The forms below are designed to facilitate and document students' clinical progress in the program. The Policies and Procedures Manual contains all the information students need to know to progress through practicum and the program. They are expected to be familiar with its entire content. The manual is updated every August. The Monthly Report Form helps students to keep track of their clinical and supervision hours during practicum. The form has to be filled out, signed by the practicum instructor, and submitted to the Clinic office every month. In order to have team hours counted, students have to fill out the Non-Traditional Hour Approval Form, have it signed by the practicum instructor, and submit it to the Clinic office.


Forms for work on an Internship or Externship site: Before students begin their Internship, it has to be approved by the MFT faculty. This is done by completing the Internship Proposal form and submitting it to the MFT faculty. The Internship Report and Externship Report form have to be filled out and submitted to the Internship Coordinator on a monthly basis in order to receive credit for client contact and supervision hours. The General Forms have to be submitted once a semester according to the instructions in the HDFS 678/88 syllabi. For those completing a non-traditional Internship, please contact the Internship Coordinator for the appropriate forms.


Resources for clinical work: Below are several resource papers that provide students with information on how to document their clinical work. The Case Notes paper explains the DAP format and gives helpful hints on what constitutes "Data" and "Assessment". The Suicide Assessment paper summarizes crucial areas to be explored and assessed when working with suicidal clients. The Treatment Goals paper gives an overview of developing treatment goals with concrete examples. Finally, the Guidelines are designed to assist students working with clients.

Client Forms

Fee Scale

For information on the sliding fee scale.


For the client information questionnaire (to bring to the first session).


For a copy of the informed consent for treatment.