Clinical Supervision Feedback Form Please enable JavaScript in your browser to complete this form.Supervisee Name *Supervisor Name *Period of supervision being reviewed *Date *Overall Experience of Supervision: I feel safe discussing my clinical work in supervision (1 = strongly disagree / 5 = strongly agree) *12345Overall Experience of Supervision: I feel able to bring uncertainties or mistakes to supervision (1 = strongly disagree / 5 = strongly agree) *12345Overall Experience of Supervision: Supervision supports my professional development (1 = strongly disagree / 5 = strongly agree) *12345Overall Experience of Supervision: The balance between support and challenge feels appropriate (1 = strongly disagree / 5 = strongly agree) *12345Overall Experience of Supervision: Supervision helps me reflect on my work with clients (1 = strongly disagree / 5 = strongly agree) *12345Overall Experience of Supervision: Supervision supports safe and ethical practice (1 = strongly disagree / 5 = strongly agree) *12345What Has Been Most Helpful? What aspects of supervision have been most helpful for you recently? (Response)What Could Be More Helpful? Are there ways supervision could better support your clinical work or development? (Response)Focus of Supervision: Case discussion (Too little / About right / Too much) *Too littleAbout rightToo muchFocus of Supervision: Skills development (Too little / About right / Too much) *Too littleAbout rightToo muchFocus of Supervision: Reflective practice (Too little / About right / Too much) *Too littleAbout rightToo muchFocus of Supervision: Ethical considerations (Too little / About right / Too much) *Too littleAbout rightToo muchFocus of Supervision: Personal impact of clinical work (Too little / About right / Too much) *Too littleAbout rightToo muchDevelopment and Learning: What areas would you like more support with in supervision? (Response)Supervisory Relationship: Give feedback to your supervisor (Yes / Sometimes / No) *YesSometimesNo About safe supports Supervisory Relationship: Disagree or question ideas in supervision (Yes / Sometimes / No) *YesSometimesNoSupervisory Relationship: Raise concerns about the supervisory process (Yes / Sometimes / No) *YesSometimesNoSupervisory Relationship: CommentsLooking Ahead: Over the next period of supervision, what would you most like to focus on? (Response)Overall Supervision Rating: Overall, how helpful is supervision for you currently? (1 = not helpful / 5 = extremely helpful) *12345Overall Supervision Rating: What might make supervision even more helpful?Submit
