Request edit access
Upstream Counselling_Clinical Supervision Contact Form

Welcome to the supervision program at Upstream Counselling! 

Thanks for inquiring about supervision with Brad and his team of clinical supervisors at Upstream Counselling. You've come to the right place!

We'd love to work with you and we care a lot about making sure you have a positive experience.

Please fill out the quick form below and we'll be in touch with you to walk you through the intake process, which starts with me getting a few more details from you and offering you times to meet with Brad Wilton, clinical director at Upstream Counselling, for a free supervisory consult/meet-n-greet.  

Thanks!
Andrea

PS: You can find more information about our supervision team here (filter by clinical supervisors): 

--
Andrea Bassett
Assistant to Brad Wilton, founder and clinical director at Upstream Counselling
Supervision Program Coordinator
Office: (226) 535-5200
supervision@upstreamcounselling.com

Sign in to Google to save your progress. Learn more
Email *
First and Last Name *
Phone number (in case we can't reach you by email). *
When would you like to start supervision?
*
Required
What's the name of the clinic you're working with or doing your practicum at? 
Are you a student?
Clear selection
Coming up next! 

We'll email you with some times to have that meet and greet with Brad, our clinical director. In that email, we'll walk you through our intake process, which includes getting your general availability, which gives us all the info we need to match you up for supervision. 

Stay tuned! 

Take care,
Andrea
Supervision Program Coordinator

andrea@upstreamcounselling.com
supervision@upstreamcounselling.com
Any questions or comments? Share them here. 

Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Upstream Counselling.

Does this form look suspicious? Report