This is an EDITABLE Microsoft word form to record practicum clock hours according to ASHA regulations (2015). I created it during my own practicum during my internship. It is appropriate for use during both graduate and undergraduate practicum clinical or educational experiences.
It contains the following sections:
Date & Time of session
Client (use initials only for HIPPA privacy)
Communication Modalities (i.e. AAC, speech supplementation, visual supports)
Other (i.e. collaboration but note that this does not qualify as ASHA clock hours).
Entered hours into database (i.e. CALIPSO Client; note you can edit database name)
Submitted for approval & Supervisor
Note: adjust margins in page settings to narrow if this document saves as two pages.