Doctoral Program

Basic Program Information

* All questions listed in red must be completed to submit your program.

Institutional Affiliation:

Department:

Submitter Name:

Email Address:

Program Title:

Program City and State/Province

Please identify the area of the "parent" program




(please specify)

Accreditation (check all that apply):




(please specify)

Degree type:



(please specify)

Intensity of training experiences offered in clinical neuropsychology (check all that apply):




Program Director:

     Email:

     Phone:

     Fax:

     Address:

Program website:

Year program was originally established:

Member of the Association for Doctoral Education in Clinical Neuropsychology (ADECN):

Average length of program (to the awarding of the doctoral degree in years):

Number of core neuropsychology faculty in parent program:



Other adjunct/consulting faculty who teach courses

Institution/Department
Specialty
Institution/Department
Specialty
Institution/Department
Specialty
Institution/Department
Specialty
Institution/Department
Specialty

Number of faculty board certified in clinical neuropsychology:

Certifying Board(s):

Is there a defined, sequential neuropsychology curriculum?


Application and Admission Information

Number of completed applications for parent program in the preceding year:

Number of applicants to parent program accepted into the program in the preceding year:

Number of applicants for neuropsychology training accepted into the parent program in the preceding year:

Number of neuropsychology training positions anticipated for the upcoming year:

Is there a separate admission process for neuropsychology:


Clarify as needed:

Application Deadline:


Training Experiences

Didactics/Coursework

Is a neuropsychology-related thesis required?

Is a neuropsychology-related dissertation required?

Does the program offer at least two courses in neuropsychology?

Does the program offer at least two neuropsychology practica in different settings?

Please indicate if and how some of the key content areas from Houston conference are satisfied (See www.theaacn.org/position_papers/houston_conference.pdf):

Foundations of clinical neuropsychology:

Functional neuroanatomy:

Clinical neurology/neuropathology:

Neuropsychology of behavior:

Neuroimaging and other neurodiagnostic techniques:

Techniques of Neuropsychological assessment:

Techniques of neuropsychological consultation:

Techniques of neuropsychological intervention:

Neuropsychology research training:

Diversity in clinical neuropsychology:

Other:

Please list the neuropsychology-related rounds/seminars/conferences graduate students can attend:

Type: (please put frequency in parenthesis after each)

Please specify other didactic training:

Type: (please put frequency in parenthesis after each)

Clinical Training

Specific Setting(s):

Other

Patient Population percentage (groups may overlap)







Please list the primary disorder(s) in your patient population in order of most frequent:

Please add additional information to be included in your listing.


Please type 'div40' into the following text box to submit.