REV 82919

F. INSTRUCTIONS FOR COMPLETING THE FIELDWORK ACTIVITY LOG

The Fieldwork Activity Log

The log is used by the student to document his/her field work activities and skills. This is a suggested form;
however, it is highly recommended that students document what they do each week (or daily) as this information
will prove very useful for future certification/licensure related issues. Further, it provides the student and
supervisor a retrospective view of the skills the student has developed and spent time performing.

Direct and Non-direct Contact Definitons

Direct Contact Activities (an in-person contact with client)

• 1:1 Individual Counseling
• Group Counseling
• Family Meetings

Non-direct Contact Activities

• Progress Note Documentation/Record keeping
• Case Management
• Research
• Professional Development
• Information and Referral
• Inservice meetings
• Staff meetings
• Telephone Contacts w/ client and or client's team

Supervision
• Weekly, individual on-site meeting with site supervisor
FIELDWORK ACTIVITY LOG
Student Name: Site Name:
Site Supervisor Name: Site Supervisor Signature:
Month (Start Date/End Date): Course Instructor:
Course: COCO 719 COCO 725 
COCO 726 Fall ____ Spring ____ 20____
Day Direct Direct Contact Activities Non-Direct Non-Direct Contact Supervi Type of TOTAL
Contact Contact Activities sion Supervision HOURS
Hours Hours Hours (Individual)
WEEK 1

WEEK 2

WEEK 3

WEEK 4

WEEK 5

TOTAL
HOURS /
WEEK