Appendix 1 ACTIVITY LOG Name: Week 1 Cum. Time Period: Hrs. 7/11/2016 0.00 Activity 7/11 7/12 7/13 7/14 7/15 7/16 7/17 TOTAL 0.00 01. Direct Tx: Integrated Care 0.00 02. Direct Tx: All Other 0.00 03. Direct Tx: Group 0.00 04. Case Consultation 05. 0.00 Organization/Administration 0.00 06. Testing 0.00 cum. = 0.00 07. Supervision: Direct 0.00 cum. = 0.00 08 Supervision: Group 0.00 09. Didactic Training 0.00 10. Treatment Team 0.00 11. Professional Development 0.00 12. Travel 0.00 13. Other: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 cum. = 0.00 14. TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 cum. = 0.00 All Direct Client Contact Supervisor: _________________________
Appendix 1 ACTIVITY LOG Name: Week 1 Time Period: Cum. Hrs. 7/11/2016 0.00 Activity 7/11 7/12 7/13 7/14 7/15 7/16 7/17 TOTAL 01. Direct Tx: Integrated Care 0.00 02. Direct Tx: All Other 0.00 03. Direct Tx: Group 0.00 04. Case Consultation 0.00 05. Organization/Administration 0.00 06. Testing 0.00 07. Supervision: Direct 0.00 cum. = 0.00 08 Supervision: Group 0.00 cum. = 0.00 09. Didactic Training 0.00 10. Treatment Team 0.00 11. Professional Development 0.00 12. Travel 0.00 13. Other: 0.00 14. TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 cum. = 0.00 All Direct Client Contact 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 cum. = 0.00 Supervisor: _________________________
Intern%20Activity%20Log.docx