Supervision Inquiry Form - Ashley Lanier-Pszczola LMFT

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Please fill out this form if you are a master's level student in MFT or a related field, new master's level graduate, pre-licensed or associate licensed therapist and are interested in receiving clinical supervision hours from me, Ashley Lanier-Pszczola LMFT.

I am an AAMFT Approved Supervisor Candidate - this means I am in the process of being mentored to become fully approved. In the state of Georgia, mentored hours count the same as AAMFT Approved Supervisor hours because my mentor is an AAMFT Approved Supervisor.

Once you complete this form, I will contact you to schedule a brief screener call where we can make sure we're a good fit, and discuss fees and what you can expect, and I can answer any questions you may have about working together for supervision.

Name *

Email address *

Phone number *

Please select the statement that best describes describes you and what you may need from supervision: *

Student currently enrolled in a master's or doctoral program in need of internship or supervision hours

Graduate of a master's program in need of AAMFT approved supervision hours (have not yet sat for the exam/applied for associate license)

Associate level therapist (LAMFT, LAPC, etc) in need of either AAMFT approved supervision hours or just general clinical supervision hours

Fully licensed therapist (LMFT, LPC, etc) in need/in search of clinical consultation

Other:

Type of supervision you are interested in: *

Individual supervision only (1-2 participants)

Group supervision only (3+ participants)

Combination of group and individual supervision

Other:

What state are you currently located in? *

Are you interested in attending supervision in person or virtually? *

In person (Ashley's office is located in Kennesaw, GA)

Virtually

Open to either/hybrid

Anything else you would like to tell me about what you're looking for?

Submit

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