Supervision Form

Fill out the form below and Christina will contact you to set up a free supervision hour where you can ask your questions and talk about your supervision need to see if Christina is a fit as your supervisor.

Supervisee Name

First Name

Last Name

Email Address

Phone

(###)

###

####

What type of supervision are you looking for?

Tell me a little about the work you are currently doing

Are you currently in supervision?

Yes

No

If yes, please describe

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