LPC Supervision Forms

The LPC Supervisor’s Toolkit is designed to get you organized and streamline your supervision practice.

 

While these forms are complete and ready for your use, feel free to edit them to fit your practice and specific needs.  These forms were created with Microsoft Word and Excel and can be edited and saved as you wish.  

 

If you are new to LPC Associate supervision, or a seasoned professional, implementing some or all of the forms in this toolkit will ensure you are completing a thorough interview of prospective supervisees, creating a legitimate and all-encompassing Supervision Contract, maintaining accurate and thorough supervision records and supervisee evaluations, and submitting the correct information to the Texas State Board of Examiners of Professional Counselors.

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Also included are tools to initiate discussions of multiculturalism and counseling implications.

 

Continued formative and summative evaluation of your supervisees is crucial to their development and essential to you maintaining your ethical and legal requirements, thus reducing your liability.

 

As a gatekeeper to the counseling profession, the use of this toolkit will help you maintain the highest professional standards and ensure your supervision practice is consistently excellent!

 

You will find the forms in this toolkit invaluable to your practice:

• Business Associate Agreement Template

• Case Consultation

• Clinical Issues Discussion

• Consent to Audio/Video Recording

• Counselor Competency Evaluation

• Counselor Evaluation of Supervisor

• Cultural Iceberg

• Creating an Intake Assessment

• Deciding How to Address Potential Legal or Ethical Violations

• Description and Application of forms

• Individual Supervision Case Discussion

• Informed Consent Template

• Informed Consent

• Intake

• Intake Assessment

• Licensed Mental Health Professionals in Texas

• LPC Brochure

• MECA Map for multicultural exploration

• New Supervisee Checklist

• Professional Development Plan

• Professional Development Plan2

• Progress Note

• Progress Note2

• Prospective Supervisee Interview

• Release of Information

• Remediation Plan

• Risk-Management Review

• Supervisee Assessment

• Supervision Contract Template

• Supervision Contract

• Supervision Hours Log

• Supervision Log Excel

• Supervisory Session Written Record (3 versions- captures all required session data)

• Treatment Plan

• Initial Treatment Plan

View some examples below!

 

After purchase, you can download the complete toolkit.

 

This toolkit has been prepared by Gilbert D. Melchor, MS, LPC-S.  I provide counseling, LPC Intern supervision, train LPC Supervisors, and am an approved LPC continuing education provider, #2520.