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COMMUNICATION SCIENCES & DISORDERS
OFF-CAMPUS CLINICAL PRACTICUM AGREEMENT
Student Name: Student Phone:
Supervisor Name: Supervisor Phone:
Site: Semester:
Student Schedule: (specify days and hours, all times student is expected to be present, policy for making up missed days due to illness, holiday coverage.)
Student Responsibilities: (state expectations in terms of caseload, lesson plans, report writing, staffing, special projects, etc.)
Supervisory Schedule: (conferences, observations, written evaluations)
Required Orientations/Readings/Other:
Student/date Supervisor/date
If components of this agreement are not met, the supervisor and student should initially attempt to resolve issue by review of stated expectations. The AAMU CSD practicum coordinator will mediate issues that continue to be a problem.
*Form adapted from University of New Hampshire CSD Department
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