Clinical Counseling
A list of available Practicum and Internship sites - updated for 2025-2026.
Click here for more information about Clinical Mental Health Counseling Practicum and Internship.
If you are planning on doing your practicum or internship at a government agency, you will be required to partake in a mandatory training session designed to familiarize you with the Illinois Medicaid Comprehensive Assessment (IM+CANS). Please complete this training before you start at your site. You may reach out to your site in order to get costs covered for training.
| Clinical Counseling Forms | Word |  | 
|---|---|---|
| Supervisee Evaluation of Site | ||
| Supervisee Evaluation of Site Supervisor | ||
| Site Supervisor’s Evaluation of Clinical Practicum Supervisee | ||
| Site Supervisor’s Evaluation of Internship Supervisee | ||
| Internship Supervisor Survey (3rd Semester Internships ONLY) | ||
| Practicum Activity Log -USE forms provided in Practicum class (Purple packets) | ||
| Internship Activity Log - USE color coded card stock FORMS (Blue-Fall, Pink-Spring, Yellow-Summer) - extra forms in wooden carousel outside GA Office Buzzard 2116 | ||
| Release for Videotaping | ||
| Application for Practicum | 
 | |
| Clinical Practicum Agreement | ||
| Application for Internship | 
 | |
| Clinical Internship Agreement | 
 | |
| Group Consent Form | ||
| Clinical Change of Supervisor | ||
| Clinical Additional Supervisor | 
A list of available Practicum and Internship sites. - updated 9/12/22
Click here for more information about School Counseling practicum and internship.
| School Counseling Forms | Word |  | 
|---|---|---|
| Supervisee Evaluation of Site | ||
| Supervisee Evaluation of Site Supervisor | ||
| Site Supervisor’s Evaluation of School Practicum Supervisee | ||
| Site Supervisor’s Evaluation of Internship Supervisee | ||
| Internship Supervisor Survey (3rd Semester Internship ONLY) | ||
| Practicum Activity Log -USE forms provided in Practicum class (Purple packets) | ||
| Internship Activity Log - USE color coded card stock FORMS (Blue-Fall, Pink-Spring, Yellow-Summer) - extra forms in wooden carousel outside GA Office Buzzard 2116 | ||
| Release for Videotaping | ||
| Group Consent Form | ||
| Application for Practicum | 
 | |
| School Practicum Agreement | 
 | |
| Application for Internship | 
 | |
| School Internship Agreement | 
 | |
| Individual Consent Form | ||
| School Change of Supervisor | ||
| School Additional Supervisor | 
 糖心视频
 600 Lincoln Avenue
 Charleston, IL 61920
(217) 581-2400
che@eiu.edu