Texas department state health services licensed chemical dependency counselor intern evaluation packet form 2026

1. Click ‘Get Form’ to open the texas department state health services licensed chemical dependency counselor intern evaluation packet form in the editor.
2. Begin by entering the date this quarterly form started and the intern's name at the top of the document.
3. For each week, complete one section of the form. Use the scoring criteria provided to evaluate performance in areas such as relationship building, counseling foundations, and clinical skills.
4. Ensure that both the supervisor and intern initial each section after completion, and record hours accrued as indicated.
5. At the end of the quarter, total all scores from each section to calculate a final score out of five hundred points. Double this score to find the percentage.
6. Remember to keep this packet for internal records; do not submit it to DSHS. It should be available for review during audits.

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