MHS CD Practicum

Communication Disorders Practicum Information

  • Practicum Manual
  • Affidavit for Practicum Manual 
  • Essential Functions for Entry into Professional Practice

Practicum Request Forms

  •  Request for Practicum in Communication Disorders     
  •  Request to Modify Clinical Practicum Sequence in Communication Disorders   
  • Required Preparation for Fieldwork Experiences   
  •  Student Emergency Release of Information   

Practicum Syllabi

  •  CDIS 8810 Practicum in Speech-Language Pathology: Special Populations
  •  CDIS 8820 Practicum in Speech-Language Pathology: School Setting
  •   CDIS 8830 Practicum in Speech-Language Pathology: Medical Setting

Clinical Clock Hours Forms  

  • Report of Clinical Observation Hours 
  • Summary of Prevention Clock Hours
  • Log of Clinical Clock Hours
  • Semester Summary of Clinical Clock Hours

Practicum Forms

  • Communication Disorders Practicum Guidelines
  • Individual Session Evaluation Form
  • Evaluation of Student's Practicum Performance
  • GovState Practicum Supervisor Grade Review 
  •  Student Self-Assessment 
  •  Student Evaluation of University Supervisor  
  • Student Evaluation of Practicum Site Supervisor and Site  
  • Site Supervisor Feedback to CDIS Program  

Practicum Project 

  • Practicum Project Sequence   
  • Requirements for Practicum Project Proposals and Final Report   
  • Practicum Project Proposal     
  • Practicum Project Proposal Review 
  • Practicum Project Guidelines for GovState Supervisors   
  • Using Single-Subject Designs in Speech-Language Pathology Practicum 
  • Single-Subject Project Instructions
  • Open Portal to University Scholarship (OPUS) 

Information and Forms for GovState University Supervisors

  • Information for GovState University Supervisors: Overview 
  • Information for GovState University Supervisors: Grade Entry 
  • Practicum Site Visit Log 

ASHA Documents

Supervision Documents

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