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Supervision Form
Fill out this form so we can schedule a meeting to discuss whether we would be a good fit for supervision.
*My aim is to respond within 24-48 business hours*
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Email
*
Your email
Full Name
*
Your answer
Preferred Name
Your answer
Pronouns
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
How do you prefer to be contacted?
*
Phone
Email
Text
Other:
Where are you at on your LAC journey?
*
Haven't graduated but getting a head start on finding my supervisor
Approved/waiting for approval from ARBOEC and need a supervisor
Looking to change supervisors
Other:
What do you hope to get out of supervision? What do you need from me as a supervisor?
(**You
may keep this brief and we can chat more when we meet**)
*
Your answer
What do you feel like your current strengths are as a budding therapist?
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Your answer
What is something you are hoping to improve or work on as you grow as a therapist? What do you feel your weaknesses are?
*
Your answer
How did you find me?
*
Word of Mouth
Facebook Group (Therapist Who Rock!, Counselor of Northwest Arkansas, etc)
Psychology Today
ARBOEC Website
Other:
Send me a copy of my responses.
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