MFT Practicum Placement Inquiry — Brain & Heart Healing, PLLC
Graduate MFT students may inquire about a practicum placement in Abilene, Texas. Brain & Heart Healing accepts a limited number of students. Stacy Reynolds, LMFT-Associate, provides supervision under AAMFT supervision mentoring and is in training toward the AAMFT Approved Supervisor designation, not yet awarded. Submitting this inquiry does not guarantee a placement. Do not include client-identifying or protected health information.
Applicant Information
Full Name
*
First Name
Middle Name
Last Name
Pronouns
University Email Address
*
example@example.com
Personal Email Address
example@example.com
Anticipated first day on site
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
University or Graduate Program
*
Program and Placement Details
Degree Program
*
Please Select
Master of Marriage & Family Therapy (MFT)
Master of Counseling, LPC track
Doctoral MFT
Doctoral Counseling
Other
Is your program COAMFTE-accredited?
*
Please Select
Yes
No
Not sure
Expected Start Term
*
Please Select
Spring
Summer
Fall
Not sure
Expected Start Year
*
Anticipated First Day on Site
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Anticipated Graduation Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Direct Client Contact Hours Required by Your Program
*
Hours Per Week Available
*
Availability
*
Weekday mornings
Weekday afternoons
Weekday evenings
Saturdays
Populations of Interest
Individuals
Couples
Families
Children and adolescents
Trauma
Substance use
Court-ordered and CPS cases (observation only)
LGBTQ+ affirming care
Telehealth
Does your program require a site supervisor with a specific credential?
*
Please Select
Yes
No
Not sure
If yes, describe the requirement
Why are you interested in this placement?
*
Relevant experience and growth goals
Do you have reliable transportation in Abilene for in-person sessions?
*
Please Select
Yes
No
Seeking telehealth-only
How did you hear about this placement?
Please Select
University faculty
Website
Google search
Referral
Social media
Other
Documents and Coordinator Information
Upload resume or CV
*
Upload a File
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Choose a file
Cancel
of
Upload program practicum requirements (if available)
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University practicum coordinator name and email
*
Required Acknowledgments
Acknowledgment of Supervision and Hour Eligibility
*
I acknowledge that supervision is provided under AAMFT supervision mentoring and is not yet by an AAMFT Approved Supervisor
I acknowledge that practicum hour eligibility is determined by my university and licensing board
Acknowledgment of Court-ordered and CPS-involved Cases.
*
I understand I cannot be assigned to me as a student, that I may only observe those sessions with client consent, and that my caseload will be drawn from voluntary individual, couple, and family clients.
Acknowledgment of Inquiry Status and Confidentiality
*
I acknowledge that this inquiry does not create a placement relationship
I acknowledge that this inquiry does not create an employment relationship
I acknowledge that this inquiry does not create a therapy relationship
I acknowledge that this form should not include protected health information
Submit Inquiry
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