Forms, checklists, and manuals

EPS 697 and CPP 697 Independent Studies Instructions & Form

“Incomplete” form

Graduation Application Information (Graduation Application section)

New EPS EdS and Masters graduate student orientation documentation

• Professional Disposition Evaluation Form (PDE)
  • Professional Growth Plan (PGP) Form (PDF version)
  • Professional Growth Plan (PGP) Form (Word version)
• New EPS EdS and Masters Graduate Student Orientation Presentation
• EPS Program Agreement Contract
• EPS New Graduate Student Bookmark Document

Graduate assistantship

• EPS Graduate Assistant Application (will reopen in January 2026)

Graduate scholarship (tuition waiver)

• EPS Graduate Scholarship (Tuition Waiver) Application (will reopen in January 2026)

Student Professional Development Funding

EPS Student Professional Development Application

SPECIAL INFORMATION & INSTRUCTIONS:
* Submit within the semester in which travel will occur only
* Fall semester applications will be accepted starting July 1, and must be submitted no later than September 15 (for conferences occurring 7-1 thru 12-31; all travel must be completed by 12-31)
* Spring semester applications will be accepted starting January 1, and must be submitted no later than March 1 (for conferences occurring 1-1 thru 6-30; all travel must be completed by 6-30)
* Funding can be used towards conference registration, transportation, or lodging expense only
* Ensure your letter/email of support and required support documentation are submitted promptly.
* Your application will not be reviewed until a letter/email of support is received

Also consider applying for student travel funding through the following sources:
Graduate Student Organization (GSO)
COE Dean’s Graduate Research/Travel Grant Program Application

Travel Related Information:

NOTE: As of July 1, 2023 Personal Funds cannot be used for Conference Registration, Airfare or Lodging.  Please review the EPS Department Travel Workbook for travel restrictions and instructions

• EPS Department Travel Workbook
• COE Travel Request Form 
• Authorized Driver Information – Certification valid for three-years
• Annual Travel Certification Form – Required once per fiscal year
• Current Meals and Lodging Cost Index
• Multiple Occupancy Form Instructions
  • Multiple Occupancy Form
• Post-Travel Itinerary
  • Sample EPS Travel Itinerary
• Post-Travel Mileage Log
• NAU Travel: Cost Comparisons Instructions
• Travel Policy
• Travel Training – Required once per fiscal year
• Policy Compliance Review Instructions

Purchase or Reimbursement Related Information (non-travel related):

• EPS Department Non-Travel Purchase Instructions

Records Retention Schedule

• Records Management at NAU

EPS Practicum Clinic Manual (current)
Practicum Master Syllabus (rev. 2023)
Practicum Student Confidentiality Statement

Client file documents (for Clinic)
All client file documents for the Clinic are available through our electronic health records (TherapyNotes)

Statewide Campus: Before Practicum Begins:
Before a counselor-in-training’s practicum field experience can begin, there must be an NAU Affiliation Agreement in place. This is required per NAU Policy on Affiliation Agreements.  Please review this document for further information regarding Affiliation Agreements and instructions on how to set up an Affiliation Agreement with your desired Practicum Field Site.

Documents for practicum students’ notebooks
All documents, supervision forms and time logs needed for practicum can be found in Tevera

Evaluation documents (completed by NAU Practicum Clinic Faculty)
All documents and surveys can be found in Tevera

Evaluation documents (completed by Field Supervisor)
All field supervisor forms can be found in Tevera

Recruiting clients
Free Counseling Form

Before Internship Begins:

1. Before an internship can begin, there must be an NAU Affiliation Agreement in place. This is required per NAU Policy on Affiliation Agreements. Please review this document for further information regarding Affiliation Agreements and instructions for how to set-up an Affiliation Agreement with your desired Internship site.
2. CMHC Internship Manual & Syllabus
3. Sample of a Completed CMHC internship Contract
4. Step 1, Rough Draft of CMHC Internship Contract 
5. Counseling Internship Contract can be found and completed through Tevera
6. NAU’s Internship Coverage Statement (in addition to the required individual liability all Practicum and internship students must carry)

Before Internship Begins – Supervisor Orientation, Consultation & Professional Development:

All Site Supervisor Orientation videos and handouts are accessible for review and completion through the Tevera platform

Throughout internship:

Hours logs are updated, signed and maintained through Time Track in Tevera

Mid-Point (before reaching 300 total hours):

All intern feedback and agency supervisor forms can be found in Tevera. Site supervisors and students may use the following forms as drafts before completing official evaluations in Tevera

1. CMHC mid-point and final Evaluation by Site Supervisor and Student
2. Intern Feedback for Agency Site (mid-pt)
3. Intern Feedback for Agency Supervisor (mid-pt)
4. Intern Feedback for NAU Faculty (mid-pt)
5. CMHC Faculty Link for First Contact 
6. CMHC Faculty Link for Second Contact 
7. CMHC Faculty Link for Third Contact 

Final (Near the end of internship – just before reaching 600 total hours):

All intern feedback and agency supervisor forms can be found in Tevera. Site supervisors and students may use the following forms as drafts prior to completing official evaluations in Tevera

1. CMHC mid-point and final Evaluation by Site Supervisor and Student
2. Intern Feedback for Agency Site (final)
3. Intern Feedback for Agency Supervisor (final)
4. Intern Feedback for NAU Faculty (final)
5. Agency Supervisor End of Internship Program Evaluation Form (final)
6. CMHC Faculty Link for First Contact 
7. CMHC Faculty Link for Second Contact 
8. CMHC Faculty Link for Third Contact 

Before Internship Begins:

1. Before an internship can begin, there must be an NAU Affiliation Agreement in place. This is required per NAU Policy on Affiliation Agreements. Please review this document for further information regarding Affiliation Agreements and instructions for how to set-up an Affiliation Agreement with your desired Internship site.
2. School Counseling Internship Manual (March 2022)
3. Internship timeline & checklist
4. All Counseling Internship contracts can be found and completed through Tevera
5. Sample of Completed School Counseling Internship Contract

Supervisor Orientation, Consultation & Professional Development:

1. Video #1: Overview of NAU’s School Counseling Internship, expectations and evaluation forms
2. Video #2: Overview of Supervision Models and Methods 
3. Video #3: One Free Continuing Education Unit (CEU) for Site Supervisors: Case Conceptualization Via Integral Theory
   1. Brief 1-CEU quiz for Integral Supervision video
4. Site Supervisor Orientation Quiz

Throughout Internship:

Hours logs are updated, signed and maintained through Time Track in Tevera

Mid-Point (before reaching 300 total hours):

1. Mid & Final Evaluation by School Supervisor and Student Self Evaluation
2. Intern Feedback for School Site
3. Intern Feedback for School Supervisor
4. Intern Feedback for NAU Faculty
5. SC Reflection Paper Rubric

Final (Near the end of internship – just before reaching 600 total hours):

1. Mid & Final Evaluation by School Supervisor and Student Self Evaluation
2. School Supervisor End of Internship Program Evaluation Form
3. Intern Feedback for School Site
4. Intern Feedback for School Supervisor
5. Intern Feedback for NAU Faculty
6. SC Reflection Paper Rubric

Additional Intern Resources:

1. ASCA Professional Standards & Competencies
2. ASCA Mindsets and Behaviors
3. State Certification Requirements

NAU Faculty Forms:

1. Faculty Supervisor Contact Form

EPS Practicum Clinic Manual (Spring 2017)

• Authorization for Release of Information Form
• Case Review for Quality Assurance Checklist
• Class Credit Form
• Confirmation of Group Supervision Form
• Counseling Supervision Log
• Documentation of Observation Form
• EPS Counseling Psychology Doctoral Practicum Evaluation Form
• Free Counseling Form
• Informed Consent Agreement Form
• Intake Interview Report Form
• List of Clients Log
• No-Suicide Contract
• Progress Notes Form
• Request for (Families – Couples) Services Form
• Request for (Individuals) Services Form
• Session Rating Form
• Termination Summary Form
• Treatment Planning Form
• Practicum Clinic Confidentiality Statement

EPS 608 Student Affairs Fieldwork Handbook (11-20-19)

• Student Affairs Fieldwork Contract
• Student Affairs Fieldwork Faculty Supervisor Contact Form
• Student Affairs Fieldwork Student Evaluation Form
• Student Affairs Fieldwork Student Evaluation of Faculty Supervisor Form
• Student Affairs Fieldwork Student Evaluation of On-Site Supervisor Form
• Student Affairs Fieldwork Student Evaluation of Site Form
• Student Affairs Fieldwork Weekly Narrative Reflection Form

EPS 682 Student Affairs Practicum (Internship) Handbook

• M.Ed. Student Affairs Internship Contract
• Evaluation of Student’s Internship Experiences
• Faculty Supervisor Contact Form
• Intern Evaluation of NAU Faculty
• Intern Evaluation of On-Site Supervisor
• Intern Evaluation of Site

• Ed.S. School Psychology Handbook (Fall 2016)
• Ed.S. School Psychology Handbook (April 2016)
• Ed.S. School Psychology Handbook (Summer 2020)
• Ed.S. School Psychology Handbook (Spring 2021)
• Ed.S. School Psychology Handbook (Spring 2022)

• Combined Counseling/School Psychology Doctoral Student Handbook
• Combined Counseling/School Psychology Doctoral Practicum Handbook 
• Combined Counseling/School Psychology Doctoral Student Checklist
• Intent to take Discipline Specific Knowledge (DSK) / Doctoral Comprehensive Examinations form
• NAU PhD Practicum and Fieldwork Midpoint & Final Evaluation
• Dissertation Funding Support Application