Adams State University - School of Counselor Education -  Practicum Student Evaluation of Site Supervisor & Site 2025-2026
Please read the linked instructions before completing this Google Form to ensure appropriate course and form steps are followed in order to receive form acceptance. Students must also write a comment on Blackboard under the Assignment tab that states “Completed”.

Students, please rate your site supervisor(s) and site using the scale provided below. Students may share the completed form with the site supervisor, but it is not required. If you were dissatisfied with your supervisor or site, you should contact the Clinical Coordinator. This evaluation should be completed at the end of the semester in accordance with the due date provided in the syllabus. If you had more than one site supervisor, please complete an additional evaluation form. Please indicate any site or site supervisor specific concerns in the “Comments:” section.
3 – Exceeds expectations
2 – Meets expectations
1 – Below expectations
0 – Does not meet expectations/unsatisfactory

The form must be submitted using the student's ASU email address.
Email *
Site Supervisor Name *
Student Name *
Site Name and Location *
ASU Instructor Last Name (please spell correctly)
 *
Provided useful feedback regarding my counseling skills *
Emphasized my strengths and capabilities *
Pointed out areas for growth *
Provided useful suggestions *
Accepted and respected me as a person *
Motivated and encouraged me *
Challenged me to self-explore *
Helped me to define goals for myself *
Do you believe your site supervisor was in compliance with ethical and legal standards? *
Comments *
What is your overall rating of the site supervisor's performance?  *
What is your overall rating of the site?  *
Comments Regarding Site *
STUDENT: By typing my name and date, I affirm the accuracy of the provided information.

 *
A copy of your responses will be emailed to .
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