Clinical Practicum Forms

Documentation is required for all students engaged in clinical training. Timely and accurate completion of the following practicum-related forms for each undertaken practicum is a program requirement; the responsibility rests on the student to ensure deadlines are met.

Form Deadline Responsibility for Document Submission
WSIB Student Declaration Start Date (1 Form/Degree) Student
WSIB Employer Declaration 1 month from Start Date Student
Clinical Placement Learning Contract End of the second week of September (except for the summer practicum and other off-cycle placements*) Student
Clinical Placement Student Evaluation (x2) Placement Mid-Point AND Placement End Date, as specified in the Learning Contract Clinical Supervisor(s)
Clinical Placement Clinical Hours Summary 2 wks after End Date Student
Clinical Placement Feedback (internal use only) 2 wks after End Date Student

*For the MA summer practicum and any other clinical practica not starting in the month of September the deadline for the Clinical Placement Learning Contract will be 2 weeks from the placement start date.

Note for Mac Users

Default settings on a MAC generally open Adobe Acrobat PDF files in “Preview” mode, which does not display or print the encrypted personalized data on your forms properly. You can

  • Open the PDF document using the “Open With” option and select “Acrobat Reader”.
  • Save the document using the “Save File” option and open the file directly from the Adobe Acrobat Reader program

Signatures and Other Reminders

  • All documentation submitted by the student must be received in the form of an original hard copy on, or before, the document deadline
  • Hard copy forms may be dropped off in-person to the Graduate Office or via envelope in mailroom; do not leave forms with other Psychology staff
  • Except where noted on the form, the student is responsible for obtaining all required signatures
  • Digital, wet, and e-signatures are all considered acceptable
  • Forms should always be downloaded from the website to ensure the correct form version is being used; older versions will not be accepted

Questions about the documentation and/or deadline compliance may be directed to the Practicum Coordinator.

Program Sanctioned Clinical Activities

From time to time, the program may sanction certain clinical activities that are outside of the standard practicum experience. Before initiating these clinical activities, students must complete a Program Sanctioned Clinical Activities Approval Form, which must be approved by the Director of Clinical Training and the student's academic supervisor(s). Students should familiarize themselves with the GD-PCS Policy and Procedures on Program Sanctioned Clinical Activities, which outlines the criteria and process in full detail.