Notice of Interest
Thank you for showing interest in attending a Supervision Group for only Neurodivergent Practitioners. 

This form has been designed to take interest from practitioners that identify as Neurodivergent, so that I can establish a Supervision Group in 2024. 

As I am based in the UK the times below are based on the UK clock. Practitioners from other countries are welcome to join the group if these times work for you, please complete the form below and we can discuss when we meet. (Please note that I am offering supervision as defined by UK therapy membership bodies and it is offered under UK law.)

Please complete the questions below. This form is not committing you to attend but registering your interest. 

The format of the group will be as follows:
- monthly
- online (via Zoom)
- 2 hours long
- 12 month commitment
- 6 to 8 members
- offered as an addition to your current supervision arrangement
- Each session will be £30 per person

This group will be affirming and welcoming of marginalised identities and the safety of the group will be of paramount importance.

The days and times offered below are all potential group opportunities and if I have sufficient interest I may create more than one group.

Once I have enough members that can attend a group on the same time and day I will contact you all to make arrangements for a brief initial chat and offer places to appropriate candidates. 

My aim with all supervision groups is to have a cohesive and suitable group of likeminded peers in similar situations. It may be that not all practitioners would be suitable for all groups and I reserve the right to decline offering a place in a group.

You can find more information about me here: www.lorrainecookson.co.uk

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Full Name *
Email *
Do you identify as neurodivergent? (self diagnoses is valid) *
Please let me know your professional title: *
In which country are you primarily based? *
Please indicate all that you can attend: *
Yes
No
Monday at 9-11am
Monday at 9:30-11:30am
Wednesday at 6-8pm
Friday at 9-11am
Friday at 9:30-11:30am
Friday at 12:30-2:30pm
Would you like me to add your email to my mailing list so you can stay updated on my latest news? *
So as not to hold your personal information for longer than necessary your response to this form will be deleted by the end of 2024, if not before.  *
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