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Supervision Hours Supervisor: Makungu M. Akinyela, MFT, Ph.D. AAMFT Supervisor in Training

Supervisee’s Name: _______________________________ Expected License: _____________ Signature

Hours

Date

1.

______________________________________

_____

_________

2.

_______________________________________

_____

_________

3.

______________________________________

_____

_________

4.

______________________________________

_____

_________

5.

______________________________________

_____

_________

6.

______________________________________

_____

_________

7.

______________________________________

_____

_________

8.

______________________________________

_____

_________

9.

______________________________________

_____

_________

10.

______________________________________

_____

_________

11.

______________________________________

_____

_________

12.

______________________________________

_____

_________

13.

______________________________________

_____

_________

14.

______________________________________

_____

_________

15.

______________________________________

_____

_________

16.

______________________________________

_____

_________


Supervision Hours Record