Petition for Change in Practicum or Internship Site - Western 2025

1. Click ‘Get Form’ to open the Petition for Change in Practicum or Internship Site - Western in our platform.
2. Begin by entering your personal information, including your name, address, city, state, zip code, and contact numbers. This ensures that your petition is properly identified.
3. Select the program you are enrolled in: either Clinical Mental Health Counseling or Marriage and Family Therapy. Then indicate whether you are in Practicum or which semester of Internship you are currently enrolled.
4. Fill in the name of your Faculty Supervisor/Instructor. This is crucial for communication regarding your petition.
5. In the provided section, clearly describe the reasons for seeking a change in your practicum or internship site. Be specific and avoid generic responses.
6. Indicate if you have discussed this matter with your Site Supervisor and summarize the conversation details.
7. Review the understanding statement about submitting this form electronically to ensure compliance with university policies.
8. Once completed, save the document using the specified naming convention before printing it out for signature.

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