APPLICATION FOR PSY.M. DEGREE
Clinical Psychology
The PsyM degree is not a terminal degree and will be awarded to students matriculated in the
doctoral program who have completed the requirements of their program as indicated below.
No incomplete grades can be remaining on your transcript in order to receive the PsyM.
Please make sure appropriate waivers have been completed and signed prior to indicating
you have waived courses. For substitutions, indicate substituted course taken and date.
PLEASE DELIVER FORM TO JULIE SKORNY, ROOM A343, FOR SIGNATURE.
Name
Year Entered Program
Advisor
List the semester and year the following courses were completed or waived. Minimum total 42
credits.
18:820:502 -Theor. Fdnts Systems
Completed
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Waived or Transferred
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18:820:503 -Theor. Fdnts Analytic
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18:820:504 -Theor. Fdnts/ Cognitive Behavior_________________
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18:820:531- Systematic Obs. & Interviewing _________________
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18:820:634- Psychodynamic Interview
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18:820:635- Cognitive Behavioral Assessment_________________
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18:820:565-Adult Psychopathology
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18:820:563-Child Psychopathology
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18:820:632- Cognitive Assessment
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18:820:581-Basic Statistics
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18:820:613- Ethical Standards and Prof Dev. _________________
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18:820:505 – Cognitive & Affective Psych
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18:820:506 - Social Developmental
Foundations of Human Behavior
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18:820:550- Systems of Psychology
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18:820:593-Community Psychology
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At least one of the following courses:
18:820:622 Biological Bases of Behavior
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18:820:570-Psych. Interv. With Ethnic &
Racial Minority Clients & Families or
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18:820:575 - Diversity & Racial Identity
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18:820:585 - Advanced Statistics
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6 or more credits from any GSAPP courses and please make sure to include course numbers
and date taken
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2 practicum credits over 4 semesters (0.5 per semester). Please indicate course numbers and
dates taken)
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Date Completed General Comprehensive Exam ____________
Clinical Case Question __________________
This student has satisfactorily completed all requirements for the PsyM degree.
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Program Administrator
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Chair, Department of Clinical Psychology
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Date
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Date