MFT Faculty Leave Makeup Group Request

Faculty Leave University Supervision Make-up Group Request

Marriage and Family Therapy Programs
This form should ONLY be completed if your assigned faculty will be on leave.

IF your assigned faculty is holding group at the typical time and you cannot attend, you will need to sign up for a make-up time using this link: https://generalappointmentscheduling.as.me/makeupclass Pleasecarefully review the following information about these make-up groups:
- Your clinical faculty's permission is required to attend these make-up groups
- There are only two make-up options each week for students who cannot attend their regularly scheduled group
  - Thursdays at 12 pm Pacific/1 pm Mountain/2 pm Central/3 pm Eastern
  - Fridays at 6 am Pacific/7 am Mountain/8 am Central/9 am Eastern
- The make-up groups will be one hour in length and students must attend for the FULL hour and be on camera in order to count their direct therapy hours that week.
- No presentations will be done during the group.
- Engaging in more than one make-up group per class can put students behind in their course, lead to the need for extensions, and delay graduation. Therefore, make-ups should be used sparingly.
Student Name*

First NameLast Name
Student Email*
example@example.com
Faculty Email*
Which course are you currently enrolled in?*

Practicum IPracticum IIInternship IInternship IIInternship Extension CourseCapstoneDoctoral Practicum Course (PhD)Doctoral Practicum Course (DMFT)Doctoral Supervision Course (MFT8971)
How many weeks is your faculty on leave?
Are you available for the same day and time for all weeks needed?

YesNo
Date of Faculty Absence*

MonthDayYear
Date
First choice for makeup group*
Select a different time for each group
Second choice for makeup group*
Select a different time for each group
Third choice for makeup group*
Select a different time for each group
Please indicate preferred time zone:*
Indicate your time zone here:*
For Admin Use Only

Students do NOT mark beyond this point
IMPORTANT - It is your responsibility to attend the requested make-up session indicated below. Failure to attend this requested session could impact your clinical hours, and future make-up session requests may not be honored.
Type of Group
Practicum Day and Time
Internship Day and Time
Confirmed Make-Up Group Date:

MonthDayYear
Date
Confirmed Practicum Faculty Member Name
Confirmed Internship Faculty Member Name
Makeup Group Details
Zoom Link
Make-Up Group Faculty Name
Makeup Group Faculty Email
Additional Information

As long as make-up group is attended, therapy hours accrued during week of missed NU group CAN count towards graduation requirementsDMFT students enrolled in DMFT-8951 cannot miss more than two university group supervision sessions without attending a make-up group. Make-up groups should be attended in the SAME week as the missed groupPhD students enrolled in DMFT-8951 cannot miss more than two university group supervision sessions without attending a make-up group. Make-up groups should be attended in the SAME week as the missed group. If students miss university group supervision without attending a make-up, they CAN still count therapy hours towards the total PhD clinical hours requirement.MFT-8971 students cannot miss more than two university group supervision sessions without attending a make-up group as a co-supervisor. When attending a make-up group, supervision practicum students can count the time as supervision hours, however no supervision mentoring hours can be co
Additional Comments/Notes:
Approval for student to attend makeup group:

YesNo
Notes from faculty regarding approval
Should be Empty:

Faculty Leave University Supervision Make-up Group Request

For Admin Use Only