This document contains a questionnaire for an internship program admissions data. It requests contact information and statistics about applicants, placements, and funding for both full-time and part-time interns in the current reporting year, including stipends, insurance coverage, and hours required. Response options are provided for the program setting.

1. Current Questionnaire Page (Program Admissions Data) - Internship
Internship ARO Questionnaire Item Type Response
Primary contact email Text Email
Program setting Drop-down See response options in
(select one) table below
For the YEAR-YEAR (fill in current reporting year) Internship
year:
Total number who applied to the program Number
Total number placed on a rank list Number
Total number funded full-time interns Number
Number of hours per week required of full-time intern Number
In U.S. dollars, minimum stipend for a full-time intern (salary Currency
only)
Paid health insurance provided to full-time interns Drop-down Yes; No; NA
Categorical
Total number unfunded full-time interns Number
Total number funded part-time interns Number
Number of hours per week required of part-time intern Number
In U.S. dollars, minimum stipend for a part-time intern (salary Currency
only)
Paid health insurance provided to part-time interns Drop-down Yes; No; NA
Categorical
Total number unfunded part-time interns Number
Total hours required to complete internship Number
Internship Program Setting Response Options
• Community Mental Health Center
• Health Maintenance Organization
• MedicalCenter
• MilitaryMedicalCenter
• PrivateGeneralHospital
• Private Psychiatric Hospital
• GeneralHospital
• VA MedicalCenter
• State or County Hospital
• Correctional Facility
• School District of System
• UniversityCounselingCenter
• Consortium
• Medical School
• Unknown
• Other