Self Inventory | Mental Health and Wellness

First Name *

Last Name *

Email *

You will receive an email copy of this form.

1. My long-term career goal is:

2. My area of special interest is:

3. The client whom I would most like to work with is:

4. The client whom I would least like to work with is:

5. I feel most qualified/skilled to work with:

6. I feel least qualified/skilled to work with:

7. An area of competence I would like to enhance or develop is:

8. My ideal site supervisor would have the following characteristics:

9. I feel most comfortable in a working environment with the following characteristics:

10. I have had the following professional or volunteer experience and/or coursework related to counseling:

11. My personal areas of strength which should be considered in the site selection process include:

12. My personal areas of weakness which should be considered in the site selection process include:

13. My ideal counseling internship would be a(n) _______ school/institution/clinic

performing _______ duties

with _______ (type of population)

Mental Health and Wellness - Self Inventory