Clinical Preparation Form

Clinical Preparation JotForm

The purpose of this form is to for students to begin the Clinical Preparation Process and familiarize themselves with some of the requirements.
Name:*

First NameLast Name
Preferred E-mail Address:*
Address:*
I plan to start my clinical experience:

After my 9th course (13th for >45 credit states)After all my non-clinical courses are doneI don't know yetOther
Clinical Expectations

Please indicate your understanding of the below clinical requirements
Check the box next to the statement to indicate your understanding.*
Availability

You will need to find around 12 hours a week to complete the activities associated with the clinical experience. In the box below indicate when you anticipate that you'd be available to see 5-6 hours worth of clients, participate in 2 hours of University group supervision, engage in at least 1 hour of local supervision, complete documentation associated with seeing clients (case notes, treatment plans, etc.) and engage in clinical coursework.
Please indicate the times you are available in a typical week (Monday-Sunday) for the above 20 hours worth of activities. For example, M 4-8 pm open; T 8 am- 2 pm open; F 11 am - 3 pm;.
Options

Please indicate 3 possible site options in your area and 3 possible supervisor options in your area. Students are encouraged to complete an online search and identify potential sites they are interested in.
Please list the name of three possible sites below.*
Please list the name of three possible supervisors below.*
Have you reached out to any of the above sites and/or supervisors at this time?*

Yes, I didn't receive any responses.Yes, I received positive responses (e.g., they are accepting interns).Yes, I received negative responses (e.g., they are not accepting interns).No, I have not reached out.No, I haven't reached out to any of the above, but did reach out to others.
Please provide any additional information related to your above response:
General Information regarding MFT Clinical Training:

https://www.jotform.com/SBSNU/clinical-guide
Potential Clinical Barriers

The below options are common barriers that we've seen which make it difficult for students to find an appropriate site and/or supervisor or to complete their clinical graduation requirements on time (within the 5 standard clinical courses that progress over at least a full year).
Select all that apply.

I have a full-time job.I am responsible for the caregiving of others.I live in a rural area.I do not have reliable transportation.I am associated with the military (spouse, active duty, etc.).I am concerned with my physical or emotional health.I have a rigid (hard to change) schedule.Other
Follow-Up

Please let us know how we can support you in your next steps.
Select all that apply.*

I don't need anything else from the Clinical Administrative Team at this time.I need access to the MFT Clinical Support course in D2L.Other
Thank you for taking the time to complete this form. Depending on your answers above, the clinical administrative team will reach out to you to follow-up. If you'd like to contact the clinical administrative team, please email MFTtraining@nu.edu
Should be Empty:

Clinical Preparation JotForm

Clinical Expectations

Availability

Options

Potential Clinical Barriers

Follow-Up