FACULTAD DE CIENCIAS HUMANAS Y EDUCATIVAS

PROGRAMA DE PSICOLOGÍA
FORMATO ACTA DE VISITA

NOMBRE: __________________________________________________ CÓDIGO: _______________________

FECHA DE VISITA: ___________________________ HORA: INICIO____________ TERMINO ___________

ASESOR: _____________________________________________________________________________________

SUPERVISOR SITIO DE PRÁCTICA: _____________________________________________________________

SITIO DE PRACTICA: __________________________________________________________________________

I. Objetivo(s) de la visita: ________________________________________________________________

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II. Temática(s) trabajada(s): ______________________________________________________________

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III. Observaciones: _____________________________________________________________________

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Practicante psicología Docente Asesor de Práctica Supervisor sitio de Práctica