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Supervision contract 2021
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Supervision Contract

Penny Annesley

Counsellor and supervisor (MSc BACP accred)

Supervision Contract

This agreement is to clarify how I practice and to set out the terms under which I work so that they are clear. If at any time you have any concern or query please let me know as soon as possible.

Me

My name is Penny Annesley. I’m a counsellor and these are my qualifications and experience: MSc in Counselling from University of Bristol. Diploma in Supervision.

I have been working in private practice since 2011 as a counsellor. I am an external supervisor for organisations including Unseen, Be-friend, Victim Support and Sarsas.

Fees and times

Each supervision session is 60 minutes and at present costs £60 for private work and £50 for charitable organisations. Times will be agreed between us. Sessions can either be paid for at the time or in advance, if you wish to pay for a block. Fees are reviewed annually and I will give you four weeks’ notice in advance if there is a change.

Confidentiality

All our work together is confidential and I will not disclose any information about you to a third party without your consent, subject to the following exceptions:


Records

I keep brief notes recording the themes of our supervision sessions. These are stored in a locked filing cabinet and I keep them for three years before destroying them, unless agreed otherwise. Your appointment details will be kept for seven years and then destroyed unless agreed otherwise. Any emails, texts, Whatsapp messages or other communications will be deleted within three months. Your telephone number will be stored on my mobile phone under your initials or first name only until your sessions end, at which point it will be deleted. Your contact details will be deleted as soon as we have ended supervision.

Privacy notice

There is a privacy notice on my website outlining data management procedures.

Cancellations

If you are unable to make your appointment please let me know as soon as possible, with preferably 48 hours’ notice. If less than 24 hours notice is given then I will still charge you for the session. I will also give you as much notice as possible whenever I will not be available.

Your agreement

 Please sign below to indicate that you have read and accept the form above. Thank you.

Signed (You) ……………………………………….                              Dated……………………………………….

Signed (PA) ……………………………………….                              Dated……………………………………….


Your contact details

Full name :

Date of birth:

Telephone numbers:

Email:

Address:

Please confirm whether you have made arrangements for your clients in event of accidents or other difficulties

YES/NO

Please confirm if you have made a living will

YES/NO

Supervision contract 2021                                             Ⓒ Penny Annesley Counselling 2021