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School of Education

Ph.D. Forms and Resources

 

 

 

 

Program Forms and Information | Institutional Review Board Forms | Licensure

Criminal Background Forms | Professional Affiliations | Grievance Procedures

Provided below are different forms, links to resources, and information for Ph.D. students. The majority of the forms below are available in the student handbooks, as well as in .pdf format (Adobe Acrobat 9.0) and in .doc/.docx format (Microsoft Word) from this site. Forms and applications related to departmental admissions are located in the Prospective Students or the Programs of Advanced Studies sections of this website.

 

Program Forms and Information

 

Students who wish to petition for a program variance, initiate the petition with their advisors. A written petition secures a place on the closed portion of the next faculty meeting. The results of the faculty action are recorded in the faculty meeting minutes. A copy of the minutes is also placed in the student's file.

 

Coursework
Student Program Worksheet
 
Evaluation of Practicum Readiness
Evaluation of Ph.D. Student by Department Faculty for Practicum Readiness
Verification Forms
Handbook Verification Form
Ethics Verification Form
Doctoral Student Report on Progress
Doctoral Student Report on Progress
File Audit Form

Practicum Forms:

Foundational and Advanced

Evaluation of Practicum Student by Supervisor
Student Evaluation of Supervision

Statement of Clinical Accountability Form

Statement of Monthly Clinical and Supervision Hours
Preliminary Examination

Evaluation of Preliminary Examination Part 1:

Clinical Case

Evaluation of Preliminary Examination Part 2:

Supervision Case

Evaluation of Preliminary Examination Part 3:

Dissertation Proposal

Advancement to Dissertator Status

Ph.D. Minor Agreement Form

Request for Advancement to Dissertator Status

Externship

Externship Application Plan

Statment of Clinical Accountability Form
Evaluation of Externship Student by Supervisor
Internship

Internship Application Plan

Internal Verification of Internship Readiness
 
Program Administration
Program Approval Form - Advisor Approved Actions
Program Approval Form - Faculty approved Actions
Program Approval Form - Training Director Approved Actions
Change of Advisor Form
 

Remediation Plan:

Development Guidelines

Remediation Plan Development Guidelines

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Institutional Review Board (IRB) Forms

 

All students in the department conducting research is required to complete an on-line tutorial program and and complete an IRB protocol prior to beginning research.

 

On-line training

http://info.gradsch.wisc.edu/research/compliance/humansubjects/tutorial/

How to Submit a protocol
IRB Homepage for Education Research

 

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Licensure

 

Association of State and Provincial Psychology Boards

http://www.asppb.org/

Wisconsin Department of Regulation and Licensing: Psychologist

 

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Criminal Background Forms

 

 

 

 

Professional Affiliations

 

Students are encouraged to become involved in local, regional, and national professional organizations. Provided below are links to select professional organizations.

 

American Psychological Association (APA)
American Counseling Association (ACA)
American School Counselor Association (ASCA)
American College Personnel Association (ACPA)
Wisconsin Psychological Association (WPA)
Wisconsin School Counselor Association (WSCA)

Wisconsin Counseling Association (WCA)

 

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Grievance Procedures

 

Information pertaining to policies within the School of Education grievance procedures is described on the School of Education website:  http://www.education.wisc.edu/student/grievances.asp

Students who feel that they have been treated unfairly have the right to a prompt hearing of their grievance. Such complaints may involve course grades, classroom treatment, various forms of harassment, or other issues. The following steps have been instituted within the School of Education. Any student or potential student may use these procedures except those graduate assistants whose complaint is covered by campus policies for teaching assistants.

Procedures for proper accounting of student grievances:

  • The student should speak first with the person toward whom the grievance is directed. In most cases, grievances can be resolved at this level.

  • Should a satisfactory resolution not be achieved, the student should contact the department’s Grievance and Sexual Harassment Advisor (GSH Advisor; i.e., the School of Education Equity & Diversity Committee Member) to discuss the grievance. The Academic Services Coordinator can provide students with the name of this faculty member, who facilitates problem resolution through informal channels. The Grievance and Sexual Harassment Advisor is responsible for facilitating any complaints or issues of students. The GSH advisor first attempts to help students informally address the grievance prior to any formal complaint. Students are also encouraged to talk with their faculty advisors or Training Director regarding concerns or difficulties if necessary. Information on university resources for sexual harassment concerns can be found at: http://www.wisc.edu/edrc/sexualharassment.

  • If the issue is not resolved to the student’s satisfaction the student can submit the grievance to the GSH Advisor in writing, within 60 calendar days of the alleged unfair treatment. This letter should be placed into the folder entitled "PhD program Grievances-In Process" in the Academic Service Coordinator’s office.

  • On receipt of a written complaint, a faculty committee will be convened by the GSH Advisor to manage the grievance. The departmental faculty committee will obtain a written response from the person toward whom the complaint is directed. This response will be shared with the person filing the grievance. This written response will be placed into the folder entitled "PhD program Grievances-In Process" in the Academic Service Coordinator’s office.

  • The Faculty committee will determine a decision regarding the grievance. The GSH Advisor will report on the action taken by the committee in writing to both the student and the party toward whom the complaint was directed within 15 working days from the date the complaint was received. This letter should be placed into the folder entitled "PhD program Grievances-In Process" in the Academic Service Coordinator’s office.

  • At this point, if either party (the student or the person toward whom the grievance is directed) is unsatisfied with the decision of the faculty committee, the party may file a written appeal. Either party has 10 working days to file a written appeal to the Associate Dean in charge of the School of Education’s Equity & Diversity Committee. If either party exercises this option, the letter(s) should be placed into the folder entitled "PhD program Grievances-In Process" in the Academic Service Coordinator’s office.

  • If an appeal is filed, it will be directed to the Associate Dean in charge of the School of Education Equity & Diversity Committee and will follow Grievance Procedures as outlined in this Committee.

    The Associate Dean will attempt to resolve the issue informally. Failing this resolution, the Associate Dean will, on a receipt of a written complaint, convene a subcommittee of the School’s Equity and Diversity Committee. This subcommittee may ask for additional information from the parties involved and may hold a hearing. (The Equity and Diversity Committee has established separate procedures for the resolution of sexual harassment issues from those concerning course grades.)  The subcommittee will make a written recommendation to the Dean of the School of Education who will render a decision. The Dean’s decision is binding at the college level and must be made within 20 working days from the date when the written complaint was filed with the Associate Dean. Documentation from these meetings and decisions must be placed in the folder entitled "PhD program Grievances-In Process" in the Academic Service Coordinator’s office.
  • Once the case is closed (either via a binding decision from the Dean or after 10 days have passed from the written decision from the Departmental Committee), the entire contents of the folder should be moved to the folder entitled "PhD program Grievances-Complete" in the filing cabinet in the Storage Room away from student files. Documentation of the Grievances will be stored in this folder for at least 7 years. Significant grievances that set a precedent will be stored indefinitely. 

 

The Graduate School has established policies governing student conduct, academic dishonesty, and sexual and racial harassment. The Graduate School also has procedures for students wishing to appeal a grievance decision made at the college level.  These policies are described in the Academic Guidelines, available at: http://www.grad.wisc.edu/education/acadpolicy/guidelines.html#97

 

 

For information about the accreditation status of the Ph.D. program in Counseling Psychology contact:

Office of the Program Consultation and Accreditation

American Psychological Association

750 First St., NE

Washington, D.C. 20002-4242

Tel: (202) 336-5979

Fax: (202) 336-5978

Email:  apaaccred@apa.org