Booking - Workplace Reflective Practice Sessions | Focus DFSV

Booking Form and Agreement to Terms and Conditions

This booking form is to participate in the 3 Reflective Practice sessions with workplaces (who have contracted EAP providers) focused on domestic, family and sexualised violence (DFSV).

The purpose of the sessions is to support a confidential reflective semi-structured discussion about workplace practices and challenges in responding to DFSV.

Format: Virtual | Duration: 2hrs

This booking form is to attend the set of 3 sessions (2023):

March: Wednesday 22nd March (1-3pm) (AEST)
May: Wednesday 3rd (1-3pm) (AEST)
June: Tuesday 7th (10 – 12pm) (AEST)

Facilitators: Insight Exchange Assistant Director Luke Addinsall (Qualified and accredited Mental Health Social Worker and Counsellor with extensive experience in working with men who use violence) and Insight Exchange Associate Kaylene Edson (Workplace and EAP intersection with extensive experience in workplace responses to DFSV). This booking form is to participate in the 3 Reflective Practice sessions with workplaces (who have contracted EAP providers) focused on domestic, family and sexualised violence (DFSV)

Insight Exchange is donating this opportunity to inform and support improved responses to domestic family sexualised violence.

Insight Exchange has been developed over time with international and local content experts and lived-experience expertise. Insight Exchange gives particular thanks to the Centre for Response-Based Practice, to the individual donors who make this work possible, and most significantly to the people who have shared their lived-experience insights for the benefit of many.

The Insight Exchange Team
contact@insightexhange.net

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* 1. Booking Details

Full Name:

Role:

Email:

Workplace Employer (Organisation Name):

Approximate number of overall FTE employees in the organisation:

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* 2. The organisation operates in the following areas:

Nationally (Australia)

ACT

NSW

QLD

TAS

VIC

New Zealand

Other (please specify)

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* 3. I understand and agree to the following:

Participation is free however places are limited and involvement will be limited to a mix of Workplaces (who have EAP contracts) (I will receive confirmation after booking)

Booking is for participation in all 3 sessions (Links to the sessions will be provided after my booking is confirmed)

Participation is practical and conversational - I am invited to have my camera on and to be engage in the discussion

Participation is confidential - content I raise must exclude names and identifiers of any person (client/team) and the discussion cannot be repeated outside of the session

The session is not recorded and notes are not documented or circulated. De-identified themes will be used in any external facing documentation or to bridge the discussion between sessions.

I need to email the IE Team if I cannot participate and I understand I am not permitted to allocate a replacement attendee from my organisation. Cancellations can be sent to: Kaylene.edson@insightexchange.net

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* 4. I give consent for Insight Exchange to:

	Yes	No
Name the workplace (employer organisation) I am participating from in the reflective practice discussion	Name the workplace (employer organisation) I am participating from in the reflective practice discussion Yes	Name the workplace (employer organisation) I am participating from in the reflective practice discussion No
Contact me to learn more about the value of sessions	Contact me to learn more about the value of sessions Yes	Contact me to learn more about the value of sessions No
Include me in the circulation of Insight Exchange updates (new resources/content news)	Include me in the circulation of Insight Exchange updates (new resources/content news) Yes	Include me in the circulation of Insight Exchange updates (new resources/content news) No