Let’s work together Name * First Name Last Name Email * Phone * (###) ### #### What supervision format are you seeking? Individual Group Combo Unsure When do you want to start supervision? * Rember that all supervision starts on the 1st of the month. MM DD YYYY Have you accrued any supervision hours so far with another supervisor? * If yes please note how many and describe why you are looking for a new supervisor. If no, please note "no" below. Des your job or jobs meet the criteria for clinical supervision? * Yes No Unsure Please describe your job below. * What setting or role are your working in? Please describe the clinical nature of your job duties. What are you seeking in a supervisor and in your supervision experience? * In what areas do you seek to grow professionally while under clinical supervision? Describe your experiences with past clinical supervisors. * This could be field placements or other experiences. What worked well for you? What was challenging for you? Please share a little bit about how you found me. * I have ready the Texas Administrative Code as it pertains to clinical supervision. understand the requirements. * Yes No CV or Resume Upload Please upload your CV or resume above in pdf format before clicking submit below. Thank you! I’ll be in touch as soon as possible. In the meantime feel free to check out more resources on the website!
