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CLINICAL SUPERVISION INTEREST

CLINICAL SUPERVISION INTEREST FORM

Thank you for your interest in clinical supervision with Katy Perkins Coveney, LCSW-S, CEO and Clinical Director of FindSelf Counseling. Supervision for purposes of clinical licensure is currently available for Social Workers in IL, NC, and TX.

Cost is $75 per hour. Appointments will mostly be offered on week day mornings, lunch hours, and some Saturdays. Supervision will be offered in individual and group format.

For NC Social Workers, if you are not located in the Fayetteville/Triangle area, it will be necessary to secure permission from the board for additional virtual sessions. Katy can assist with this.

Katy has been a Social Worker for nearly 20 years, with work experience in child abuse prevention, rape crisis, domestic violence, hospital, hospice, and private practice; and volunteer experience in state and national organizations. Main areas of expertise include: disordered eating, adult adoptees (domestic and international), family secrets, post adopt search/reunion, DNA discoveries, domestic and sexual violence, childhood abuse recovery, religious trauma, separating from high demand groups, burnout, and oppression & discrimination, hospital case management, hospice, end of life planning, nonprofit management, and policy advocacy.

After we receive your interest, you can expect a response within a few business days.

For more information about the practice, visit www.findselfcounseling.com
For more information about Katy, visit www.katyperkins.com

Thanks, I look forward to speaking with you! --Katy
1.First and Last Name
2.Phone Number
3.Email Address
4.For which state are you seeking clinical supervision?
5.How were you referred to Katy?
6.What specialty areas and age groups are you interested in? (example: hospice, domestic violence, ADHD; young children, emerging adults, elderly, etc) It's ok if you don't know yet!
7.Do you already have a job that is clinical in nature (assess, diagnose, and treat)?
8.I already have my LCSW-A (NC) or LMSW (TX)
9.If you've already started supervision with someone, and are looking for a new supervisor, what's the story?
10.I have access to a reliable internet connection whether at home, work, or on the road.
11.NC/TX clinical supervision requirements are for 3,000 of work and 100 hours of indiv/group meetings, over a minimum of 2 and maximum of up to 6 years. That's a lot! What do you think might be some challenges for you to attending and completing clinical supervision? (Asking so we can understand what your life is like and what kind of accommodations you might need)
12.Are you also interested in seeing any sliding scale therapy clients virtually/in person through FindSelf Counseling (Fayetteville NC)?
13.Any languages you speak besides English?
14.Please upload a copy of your resume/CV. (Required.)
No file chosen
15.What is your current work schedule, usually?