Supervision Feedback Mechanisms 
Your clinical safety and professional growth are the priority. Use this form to anonymously report concerns, instances where supervision has felt unhelpful, or issues that feel difficult to raise in person. 

All reported concerns, including the actions of any individuals involved, will be reviewed carefully in line with our ethical and professional standards. We approach every report with curiosity, fairness, and a commitment to understanding the full context, not with accusation or judgement. Our intention is to support ethical practice, strengthen the profession, and ensure that counsellors and clients are safeguarded.
Sign in to Google to save your progress. Learn more
Nature of the Concern
 
(What is the primary reason for this feedback?)
 *
Description of The "Unhelpful" Moment
 
(Please describe a specific instance or a recurring pattern where supervision did not meet your needs. What happened (or didn't happen) that felt unsupportive?)
 *
Who is involved?  *
Impact or Risk

(How is this issue affecting your clinical work with clients or your professional confidence?) *
How would you like this to be resolved?

(e.g., a change in feedback style, more focus on a specific area, or mediation/third-party involvement). *
Any other comment or concern *
If you are open to being contacted for clarification, you may leave your email
(Your email will only be used for follow-up about this concern and not shared with anyone else)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms