Month: January
Year: 2009
AAMFT CLINICAL HOURS REPORT test
University of San Diego
Name:
Marital and Family Therapy Program
Setting: test setting
THERAPY HOURS Week Beginning
INDIVIDUAL Non-Group Group
COUPLE Non-Group Group
FAMILY Non-Group Group
Client Hours
Mar 23, 2009
1
1
1
1
1
1
6
Totals:
1
1
1
1
1
1
6
SUPERVISION HOURS Week
LIVE OBSERV Group
VIDEO Indiv.
CASE NOTE
Group
Indiv.
Group
TOTAL
Beginning
Indiv.
Supervision
2009-03-23
5
5
5
5
5
5
30
Totals:
5
5
5
5
5
5
30
REMINDERS: Clinical Hours are due the 1st Monday of each month Add each column down, and each row across Week Beginning dates should all be from a single month (do not combine months) Group Supervision consists of 6 or fewer trainees No signature required on this form Complete this form using hours obtained at both Practicum Site and in USD Practicum Course Updated: March 2009 | SER
Submit by Email
Print Form