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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. ______________________________________ _____ _________

Supervision Hours Record

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8. ______________________________________ _____ _________ 9. ______________________________________ _____ _________ 2. _______________________________________ _____ _________ 10. ______________________________________ _____ _________ 11. ______________________________________ _____ _________ 12. ______________________________________ _____ _________ 13. ______________________________________ _____ _________ 14. ______________________________________ _____ _________ Supervision Hours

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Page 1: Supervision Hours Record

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. ______________________________________ _____ _________


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