Supervision Group Booking and Agreement Form


It's 2018 - a year for enhancing your expertise, your excellence and your enjoyment of your SF Brief Practice

I'm delighted that you will be joining one of the Supervision Groups. I look forward to welcoming you, and taking this learning journey together.

This is a package of 5 group meetings taking place over a semester.

You may book for one or both semesters. Payment for Semester 2 is due only in July 2017.

Please complete this form in order to secure your place.

You will receive a confirmation e-mail and an invoice. Please e-mail proof of payment to confirm your place.

Payment in full, or payment of the first monthly instalment must be made on or before the first group meeting in the semester.

NB: This is an online form - once you've submitted it, I'll receive notification immediately.

 

Please select your preferred group

Payment Option - please select the option you prefer

Please indicate in which currency you wish to make your payment. This will be reflected on your invoice

Address -  including your postal code and country - this is important for billing purposes

Please provide an indication of the extent of your education in the SF Brief Approach to date. Check as many as apply

If you indicated other, please provide short notes

Context/s and role/s  in which you will be using  SF Brief Practice this year - please tick as many as apply

If you checked "Other", please provide details

Please provide a short description of the people/clients,  and the situation/s that you will most likely be involved in as part of your SF Brief Practice ths year.

What are your best hopes about the benefits from your participation in this supervision group?

What else would you like me to know that is important to optimise your participation in this learning journey?

Agreement to Paricipate:

I am aware that sessions may be recorded. These recordings are to be used for educational purposes. When provided with access to recordings, I agree to make use of these recordings only for my personal learning. I will not share the recordings without first obtaining permission from Dr Svea van der Hoorn

PROFESSIONAL ETHICS AND DUTY OF CARE

We will be reflecting on examples from your practice - always with the focus on YOUR contribution to the interaction. Please click your agreement to the following:

1. I understand that many of the discussions include case material – examples from session with clients, transcripts, and audio/videotapes of work done. Where possible, I will avoid offering any identifying information to ensure people’s privacy and integrity are upheld.

2. When I use any material that includes identifying information, I will have obtained informed consent from the person/s to do so.

3. I agree to maintain confidentiality regarding all material shared during the discussions. Case material and audio/videotapes may NOT be copied or recorded without prior agreement from those involved.

4. I agree to participate in activities and discussions in ways that uphold the integrity, dignity and privacy of other participants and any third parties.

5. I understand that I retain responsibility for decision-making about ethics, duty of care, and practice in relation to the services that I offer. This includes when to make use of individual mentoring or supervision, or any other service / support which enables sound professional practice.

6. If I belong to a professional or regulatory organisation, eg ICF, HPCSA etc, I will make sure I work within the remit of their guidelines for standards of practice, and will abide by their Code of Ethics.

7. If I am involved in any client concern or complaint that involves ethics or standards of practice, I will make this known to the supervisor immediately via personal communication. I accept that these group supervision meetings cannot replace individual supervision. These meetings also cannot be a substitute for obtaining advice and support from a professional indemnity insurance or legal organisation / person when faced  with a poor practice or malpractice complaint.