Please complete the Attestation Form upon completion of your internship/practicum activities for the Spring 2025 semester – around the end of April or early May for most students. Forms submitted prior to this time will need to be resubmitted.

Student Attestation: My internship/practicum has consisted of at least two of the following activities: direct interaction with persons in a therapy setting, observation of therapy sessions, and/or completing/reviewing clinical documentation. I hereby confirm that I have met the above requirements as well as all requirements for my internship/practicum course. I confirm that my internship/practicum work was supervised as required by my internship/practicum course and have verified this with my professor. I confirm that my internship/practicum site is a community mental health center, non-profit mental health treatment provider, or within the state psychiatric hospital system. By signing my name below, I attest that the above statement is true and valid to the best of my knowledge.