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Supervision Inquiry Form

Please complete the following form for initiating contact with me about supervision. Before contacting me, please review the rules around clinical supervision and make sure you meet requirements for LCSW supervision. Those can be found by reading  Texas Administrative Code RULE §781.402, Clinical Supervision for LCSW and Non-Clinical Supervision for Independent Practice Recognition. 

Supervision Format you are seeking:
Individual
Group
Combo
Unsure
Does your job meet criteria for clinical supervision?
Yes
No
Unsure
I have read the Texas Administrative Code section on clinical supervision and understand the rules and requirements
Yes
No
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