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State of Ohio COUNSELOR SOCIAL WORKER MARRIAGE AND FAMILY THERAPIST BOARD 77 S High St. 24th Flr Rm 2468 Columbus OH 43215-6171 614-466-0912 - Fax 614-728-7790 www. Cswmft. ohio. gov - cswmft. info cswb. ohio. gov Internship and/or Practicum Evaluation Rating Form This form must be submitted along with transcript s when applicants from a non-COAMFTE accredited program request to sit for examination Part A TO BE COMPLETED BY THE MARRIAGE AND FAMILY THERAPIST TRAINEE NAME First Middle Last...

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