Get the free Intern Plan and Agreement of Supervision Form - dshs state tx

This form is required for speech-language pathology interns to establish a supervision plan with their supervisors according to Texas Board rules and ethics.

How to fill out intern plan and agreement

How to fill out Intern Plan and Agreement of Supervision Form

1. Gather necessary information about the intern and supervising organization.
2. Review the sections of the Intern Plan and Agreement of Supervision Form.
3. Begin filling out the intern's personal details such as name, contact information, and educational background.
4. Outline the internship objectives and learning outcomes in the appropriate section.
5. Specify the duration of the internship and expected working hours.
6. Include details about the supervisor's name, title, and contact information.
7. Define the roles and responsibilities of both the intern and the supervisor.
8. Include any necessary signatures from the intern, supervisor, and educational institution if applicable.
9. Review the completed form for accuracy and completeness before submission.

Who needs Intern Plan and Agreement of Supervision Form?

1. Students seeking internships to gain practical experience.
2. Educational institutions requiring structured internship programs.
3. Supervisors or employers offering internship opportunities.

People Also Ask about

How many slpas can an SLP supervise in Texas?

Texas Speech-Language-Hearing Association Supervises a maximum of 4 individuals (any combination of interns and SLP-Assistants). activities) regardless of full-time or part-time status of the SLP-Assistant. Additional indirect supervision may be required depending on the SLP-Assistant's skill and experience.

What are the responsibilities of a SLPA supervisor?

Develop, review, and modify treatment plans for students, patients, and clients that the SLPA implements under the SLP's supervision. Make all case management decisions. Adhere to the supervisory responsibilities for SLPs. Retain legal and ethical responsibility for all students, patients, and clients served.

What does a CF supervisor do?

Indirect supervision/other mentorship activities typically include reviewing diagnostic reports, treatment records, and plans of treatment; monitoring the Clinical Fellow's participation in case conferences or professional meetings; and/or evaluating the Clinical Fellow's work by consulting with colleagues or clients

How many hours does a CF SLP need to be supervised?

This equates to 18 hours of direct and 18 hours of indirect supervision during the full CF experience. You may provide more supervision if your local or state policies require more, or if you feel that your Clinical Fellow would benefit from more supervision.

What does a CFY supervisor do?

Indirect supervision/other mentorship activities typically include reviewing diagnostic reports, treatment records, and plans of treatment; monitoring the Clinical Fellow's participation in case conferences or professional meetings; and/or evaluating the Clinical Fellow's work by consulting with colleagues or clients

What are the duties of a clinical supervisor?

Functions of a Clinical Supervisor You are the primary link between administration and front line staff, interpreting and monitoring compliance with agency goals, policies, and procedures and communicating staff and client needs to administrators.

For pdfFiller’s FAQs

What is Intern Plan and Agreement of Supervision Form?

The Intern Plan and Agreement of Supervision Form is a document that outlines the structure and expectations of an internship program, including the roles of the intern and supervisor, as well as the goals and activities to be undertaken during the internship.

Who is required to file Intern Plan and Agreement of Supervision Form?

Typically, both the intern and the supervising organization or individual are required to complete and file the Intern Plan and Agreement of Supervision Form to ensure that all parties are aligned on the internship's objectives and logistics.

How to fill out Intern Plan and Agreement of Supervision Form?

To fill out the Intern Plan and Agreement of Supervision Form, one should provide detailed information about the internship, including the intern's name, contact details, the supervisor’s name, internship start and end dates, the internship objectives, tasks to be performed, and any evaluation criteria.

What is the purpose of Intern Plan and Agreement of Supervision Form?

The purpose of the Intern Plan and Agreement of Supervision Form is to formalize the internship agreement between the intern and the supervisor, ensuring that there is clear communication regarding responsibilities, expectations, and assessment methods throughout the internship.

What information must be reported on Intern Plan and Agreement of Supervision Form?

The Intern Plan and Agreement of Supervision Form must report information such as the intern's name, the supervisor's name, the internship duration, the objectives of the internship, tasks to be performed, meeting schedules, assessment methods, and any specific policies or requirements of the internship program.