Clinical Supervision Request Questionnaire
Hello!  Thanks for taking the time to fill out this form and considering me for your journey of licensure.  To streamline the process and to be sure we are the appropriate match please fill out this contact form.  Thank you!
Name *
First and last name
Email *
Phone number *
Why did you choose the world of therapy? What was your favorite class in grad school? *
Why are you interested in clinical supervision with me? *
What would you say are your two greatest weaknesses? Strengths? *
If I told you that you could only work with one type of client with one presenting issue...what would you want to do all day? *
What do you do for postgraduate training/CEUs? *
What do you do for fun? *
What motivates you? Frustrates you? *
If you started supervision with me - what is something you would be disappointed about if it didn't happen or wasn't part of your supervision? *
What's the best way for you to receive feedback and the worst way? How will I know if you aren't receiving feedback well / it's not feeling helpful or growing you? *
Describe your favorite boss and your least favorite boss and why. *
Tell me about a time you had really tough feedback from a supervisor, and how you negotiated that. *
What do you do for moment to moment self-care when you are extremely stressed, under pressure, and unable to do things like massage, yoga, or exercise? *
How do you deal with pressure or stressful situations? *
What are your long-term goals? Where do you see yourself in 5 years? *
What is your niche or population(s) you feel called to help? *
What days and times are you available for supervision? *
Have you been in supervision before? *
Required
How would your best friend describe you? *
Do you have any questions for me? *
Thank you for taking the time to respond.  We will reach out shortly.  
If you haven't already, please email the Qualified Supervisor, Yvette E. McDonald, your resume at yvette@travelinglightcounseling.com 
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