A Professional Clinical Counseling Intern has a master level degree in mental ... and has been approved by the Californi
Individual, Couples & Family Therapy | Bonnie J. Rumble, MFT • License #MFC 31229 760-732-1539 |
[email protected] Vanessa J. Laterneau, Professional Clinical Counselor Intern PCCI #1192 under supervision of Bonnie J. Rumble, MFT • License #MFC 31229
Internship Counselor Release A Professional Clinical Counseling Intern has a master level degree in mental health counseling and has been approved by the California State Board of Behavioral Science to practice under the supervision of a counseling professional. As a licensed Marriage and Family Therapist, Bonnie Rumble, MFT License #MFC 31229 will supervise all interns practicing under her or employed by Cardiff Counseling Center. Limits of confidentiality The counseling intern may at times discuss aspects of your sessions with Bonnie Rumble MFT, during regularly scheduled supervision sessions. This is vital as part of the internship and licensing process. As a client I have read, understand and agree to all terms for meeting with an intern for mental health counseling. _________________________________________________________ Client’s Signature
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_________________________________________________________ ____________ Counselor’s Signature Date _________________________________________________________ ____________ Bonnie Rumble, MFT Lic# 31229 Signature Date
Located at 2047 D San Elijo Ave., Cardiff, CA 92007 & 3821 Front Street, San Diego, CA 92103 www.cardiffcounselingcenter.com
