Sample Time Log for Tracking Practicum Hours

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PRACTICUM
TIME SHEET
Department of Psychology
NAME ________________________________
DATE from____________to_______________
SEMESTER __________________/_________
DATE
Sub-totals
Direct Client
Contact
Indirect Client
Contact
(note/report
writing, phone
calls)
Peer Observation
Individual
Supervision
Group
Supervision
Group Case
Staffing
Tests/Assessment
Administration
Other (specify)
SUBTOTAL
Signature of Student ____________________________
Signature of Site Supervisor _________________________
Grand total of hours _____________
(For all pages summed)
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