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Lynchburg College Counselor Education Program
Practicum Site Supervisor Verification Form
Thank you for your willingness to serve as a site supervisor. Your efforts are an invaluable contribution
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How to fill out practicum site supervisor verification

How to fill out practicum site supervisor verification
01
Obtain the practicum site supervisor verification form from your academic institution.
02
Fill out the top section of the form with your personal details, such as your name, student ID, and the name of your academic program.
03
Provide information about your practicum site supervisor, including their name, title, and contact information.
04
Indicate the dates of your practicum and the number of hours you have completed at the site.
05
Attach any supporting documents required, such as signed evaluation forms or log sheets.
06
Sign and date the verification form.
07
Submit the completed form to the designated department or person at your academic institution for further processing.
Who needs practicum site supervisor verification?
01
Practicum site supervisor verification is typically required by students who are enrolled in a program that includes a practical work experience component.
02
This may include students studying fields such as education, social work, counseling, psychology, nursing, and various other disciplines.
03
The verification serves as evidence that you have completed the required practicum hours and have received supervision and support from a qualified professional.
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What is practicum site supervisor verification?
Practicum site supervisor verification is a process by which a designated supervisor at a practicum site confirms that a student has completed their required field practice or internship hours and competencies.
Who is required to file practicum site supervisor verification?
The site supervisors who oversee the practicum or internship experiences of students are typically required to file the practicum site supervisor verification.
How to fill out practicum site supervisor verification?
Practicum site supervisor verification is filled out by providing details such as student information, practicum site details, supervisor's signature, and confirmation of hours completed and competencies achieved.
What is the purpose of practicum site supervisor verification?
The purpose of practicum site supervisor verification is to ensure that students receive appropriate supervision during their practical experience and to validate that they have met the necessary requirements for their program.
What information must be reported on practicum site supervisor verification?
The practicum site supervisor verification must report the student's name, the practicum site's name and address, the semester or time period of the practicum, the total hours worked, and the competencies achieved.
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