New Clinical Staff

Welcome to the staff of Mid-Ohio Psychological Services.  These aids are designed to make your orientation to the agency easier.  Please contact your supervisor with any questions regarding this material.

Pre-employment Paperwork

        Application for Employment

        Conflict of Interest Form

        Emergency Contact Form

        Policy and Procedure Verification Form

        Code of Conduct Form (New Employee)

        Ohio New Hire Reporting Form

        Confidentiality/Security Agreement

        Job Description (Scroll to your specific job category)

        New Clinician Checklist

        New Employee Checklist

        New Employee Orientation Checklist

        Ohio IT-4 Form

        I-9 Form

        W-4

        Substance Testing Consent Form

        Direct Deposit Form

        Pay Rate Sheet

        New Employee Notification

        Instructions for Background Check

        E-Training Instructions

        Instructions for Pre-Employment Drug Testing

        New Employee Checklist (All Staff)

        New Employee Orientation Checklist (Clinical Staff)

        MOPS Office Locations

        Change of Schedule (to be used to establish schedule in Xakt)

Timesheet/Payroll Paperwork

        MOPS Clinical Time Sheet Guidelines

        Clinical Timesheet (save on your local machine when using)

        SAL/Scheduler Guidelines

        SAL/Travel Log

        Payroll Schedule & Due Dates

        Request for Leave

Supervision Forms

        Supervision Guidelines for Internship Supervisors

        Psychology Board Supervisee Registration Form

        Counselor Board Supervisee Registration Form   

        Credentialing/Scope of Practice Form

        Supervision Log (APPIC)

        Supervision Log (other clinicians)

        Supervisory Agreement - Master's Level

        Supervisory Agreement - Doctoral Level

        Supervisory Agreement--Misc.

        Supervisor Feedback Form

        Professional Disclosure Statement Sample (psychology)

        Professional Disclosure Statement Sample (counseling)

        Statement of Supervisory Relationship Sample

        Statement of Supervisory Relationship (editable--to be handed out to every client)

Diagnostic Assessment Paperwork

        Diagnostic Assessment Workflow

        Psychosocial History Instructions - Adult

        Psychosocial Intake Form - Adult

        Psychosocial History Instructions - Juvenile

        Psychosocial Intake Form - Adolescent/Child

        House-Tree-Person, Bender Gestalt, and Draw-A-Family Forms

        DSM-IV-TR Quick Reference

        GAF Guidelines

Examples Diagnostic Assessment

        Psychosocial Intake Form Sample

        Genogram Sample

        House-Tree-Person Sample

        Bender Gestalt Sample

        Draw-A-Family Sample

        Diagnostic Intake Note Sample

Documentation of Sessions       

        Case Note Structure and Types

        Structure of a Case File

        Charting Aids

        Coping Skills/Social Skills

        Proofreader's Marks

        MACSIS Instructions

        MACSIS Intake Help Sheet

        Case Compliance Checklist

Using CIS/SOC/E-Dictate

        Case Notes in CIS

        ISP's in CIS

        Standards of Care Website Guide

        Express Dictate Aids

        Computer Changes at Fairfield Academy

        Computerized Testing Access

        Closing a Case/Closure in CIS

        Accessing MOPS Training Resources (eTraining and NetSmart)        E-Training

Policy and Procedure/Job Description

        MOPS Policy and Procedures Guide

        MOPS P&P Section XXX:  Psychology Predoctoral Interns

        Job Description

        MOPS Client Recording Policy

        Consent to the Use of Photography and /or Audio/Video Tape Recording

Supervision/Performance Review

        Clinical Observation Protocol           Intern Feedback Form

        Expectations for Clinicians

        Supervision Guidelines for Interns

        Monthly Personnel Review

        Psychology Trainee Competency Assessment Form (APPIC Interns)

        Goals for Internship

Correspondence Samples

        Non Custodial Parent Letter Sample

        Re-engagement Letter Sample

        Session Attendance Form Sample

Ethical Code & Ohio Administrative Code regarding Supervision and Professional Conduct

        Ethical Principles and Code of Conduct--Psychology

        Ethical Code of Conduct--Counselors

        OAC 4732-13 Supervision--Psychology

        OAC 4732-17 Rules of Professional Conduct--Psychology

        Ohio Counseling Laws and Rules

IQ Testing Resources

        Subtest Structure of the WAIS-IV

        Subtest Structure of the WISC-IV

        Developmental Presentation of Intellectual Disability

Psychological Evaluations

        Evaluation Dictation Guide           Psychological Evaluation Sample

        Common Psychological Evaluation Questions

Sexually Aggressive Youth Treatment

        Fairfield Academy Program Description

        SAY Service Matrix

        SAY Treatment Planning

        Etiology of Sexual Deviancy

        WV Children Services Contact List (For Fairfield Academy)

ADAMH Board Agencies

        ADAMH Board of Franklin County System of Care Brochure

        Franklin County ADAMH Board Providers-- "Network Providers"         "Medicaid Only Providers"

        Fairfield County ADAMH System Providers 

        Licking County ADAMH Board Providers "Network Providers"

ODMH Glossary

OPA & Credential Banking Information

    Joining OPA

    OPA New Member Application

    ASPPB Credentials Bank Information

    National Register Credentials Bank Information

Last modified: January 03, 2012