Forms & Intake

Each form below is self-contained. Your responses are never uploaded — the PDF is generated locally in your browser so you can review it before sending. If you prefer, print the downloaded PDF, sign it by hand, and scan.

§1

Supervision Inquiry

Introduce yourself, your training context, and what you hope to get from supervision. This is the first step for a prospective supervisee.

§2

Professional Disclosure — Acknowledgment

Sign to confirm you have read the Professional Disclosure Statement and understand credentials, orientation, fees, and confidentiality.

§3

Supervision Contract — Signature Page

Accept the terms of the supervision contract and generate a signed signature page. The full packet remains available on the Contract page.

Full name *Email *Program Term start Term end

I agree to attend one 60-minute weekly individual supervision session and one 90-minute weekly group supervision session (capped at four supervisees).I agree to submit weekly documentation, including direct/indirect hours, caseload updates, and supervision notes by the agreed deadline.I agree to bring recordings or written case material for review at least every two to three weeks.I understand supervision is evaluative and that formative and summative ratings will be shared with me and, where applicable, with my program.I understand and accept the limits of confidentiality: risk of harm, mandated reporting, ethical or licensure concerns, and supervisor-of-supervision consultation.I agree to follow the ACA Code of Ethics and ACES Best Practices, and to raise ethical or clinical concerns as they arise.I understand the process for cancellation, absence, and remediation as outlined in the full contract packet.

Typed signature *Date *

Please accept every term before signing.

§4

Supervisee's Bill of Rights — Acknowledgment

Sign to confirm you have read and understand your rights as a supervisee in our working relationship.

The right to a supervisor who is competent, ethical, and appropriately credentialed.
The right to a written contract outlining goals, methods, evaluation criteria, and confidentiality limits.
The right to regular, scheduled supervision sessions of adequate length and frequency.
The right to timely, specific, and behaviorally anchored feedback — formative and summative.
The right to advance notice of concerns about my performance and a written remediation plan when needed.
The right to due process in evaluation, remediation, and gatekeeping decisions.
The right to supervision that respects and attends to my cultural identity, values, and lived experience.
The right to raise concerns about the supervisory relationship and to seek consultation or reassignment when necessary.
The right to confidentiality about my personal information within the ethical limits of supervision.

Full name *Email *

I have read the Supervisee's Bill of Rights and understand my rights as a supervisee.

Typed signature *Date *

Once you have downloaded your signed PDF(s), attach them to an email to cady.barbour@gmail.com with the subject line Supervision — [Your Name]. I will confirm receipt within three business days and schedule an initial meeting.

Supervision Inquiry

Professional Disclosure — Acknowledgment

Supervision Contract — Signature Page

Supervisee's Bill of Rights — Acknowledgment

Next Steps