Clinical Reference for Doctor of Psychological Science (Clinical

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					Clinical Reference for Doctor of Psychological Science (Clinical Psychology)
PAC application number (applicant please supply) _____________
Referees are asked to place the completed form with any additional documentation they provide into a sealed
envelope, signed by the referee on the seal.*

1. Name of applicant: ________________________________

2. Title of primary degree: _____________________________

3. Contact with applicant: (In what capacity have you known the applicant and for how long?)

________________________________________________________________________________
Please provide your comments on the applicant’s suitability for training as a clinical psychologist. In particular, comment as best you
can on: ability to develop positive working relationships with clients; ability to work constructively with colleagues; ability to achieve a
balance between autonomous work and constructive use of supervision; ability to manage the substantial demands of Doctoral level
clinical training. Please comment on the applicant’s personal suitability for a career in clinical psychology. Please outline the particular
strengths of the applicant and also any weaknesses you think may be relevant such as personal unsuitability, high absenteeism etc.
  (Please type in size 10 font – an additional page may be used if necessary)




Bearing in mind the highly competitive application process, please rate the applicant overall in terms of their suitability for
clinical training:

   Weak                   Fair                 Strong               Very Strong                Outstanding


Signed by: _______________________ Title: _______________________________________                                 Date: _____________

Please return completed forms to: Postgraduate Applications Centre, 1 Courthouse Square, Galway, Ireland.