CPCS Supervision Forms 


 Supervision Forms

Why use the Industry Standardized Supervision forms?  License Law    and board rules

  • We have seen a 60% increase in supervision audits at the Licensing Board due to supervision paperwork discrepancies.
  • As a result,  there have been “denials” of their application
  • Applicants have had to testify (justify) at a Composite Board hearing; supervision. 
  • The CPCS Committee and a host of others worked to identify the issues and help provide a working solution.

Using the new Industry Standardized Supervision forms (correctly filled out) can minimize the chance of application denials, saving both supervisors and supervisees valuable time and money!!!

SUPERVISION FORMS:  Click on the titles below to download the pdf/xlsx forms.  LPCA members who would like the forms in MS Word Docx (that is the newer version of Word) can email us at the following: CPCS@LPCAGA.org

SAMPLE CONTRACT between Supervisors and Supervisee CLICK HERE

Summary of Supervision Hours Individual Summary of Supervision Hours
Supervision Notes "the Logs" Supervision Notes "the Logs"
Non-Clinical Supervision Notes Directed Experience Log  click here


 The Clinical Supervision Toolkit  Click Here  To order a printed Booklet Copy of the Clinical Supervision Toolkit  Click Here

The Supervisory Relationship Questionnaire SRQ  https://www.midss.org/sites/default/files/srq.pdf

 Complaint About a Supervisor?  CLICK HERE