Professional Supervision Agreement

Professional supervision at Be You OT aims to support you to embody your OT role safely, competently and according to best practice.

This agreement outlines the terms and expectations guiding the professional supervision relationship between yourself and Be You OT.

Your Details

First Name *

Last Name *

Date of Birth *

Pronouns *

Your Neurotype (if you'd like for us to know)Self-identification is a valid and meaningful way to understand your neurotype. You don’t need a formal diagnosis to recognise patterns in how you think, feel and engage with the world. If you self-identify as autistic for example, even without a formal diagnosis, this is still a valid and recognised neurotype.

Mobile Number *

Email *

Postal Address *

AHPRA Registration Number *

Employer

Terms of Supervision

DELIVERY OF SUPERVISION

Supervision is delivered via Zoom at a frequency of your choice. Kimmy can provide guidance on an optimal frequency based on your needs, stage of practice and supervision goals. Sessions are booked in Queensland (AEST) time.

CANCELLATION POLICY

You can reschedule your supervision session up to 72 hours prior to your scheduled session. If you need to reschedule your supervision within 72 hours of your scheduled session or if you don't attend your scheduled session, this will be considered a late cancellation and a cancellation fee will be charged to the value of one supervision session.

I have read and agree to the cancellation policy. *

Yes

SUPERVISION MODELS

Your supervisor will draw on the Model of Occupational Wholeness to frame supervision, as well as referencing to the 4x4x4 Model of Supervision.

CONTENT OF SUPERVISION

You'll have access to an online agenda form or you can send Kimmy an email with topics for discussion. Kimmy appreciates receiving agendas at least 24 hours prior to scheduled session to give her enough time to read them prior to your sessions. You can change your agenda at the time of your session if this is of benefit to you.

SUPERVISION FEES & INCLUSIONS

Individual supervision is billed at $220 + GST per 50-minute session. This includes a detailed follow-up email summarising the session content, key reflections, relevant resources and/or suggested steps to support integration and planning between sessions.
Joint supervision (2 people per session) is billed at $120 + GST per 50-minute session, per person. A follow-up email will be provided summarising shared content and offering reflections and resources relevant to both supervisees.
Group supervision (3–4 people per session) is billed at $100 + GST per 50-minute session, per person. A follow-up summary will be provided to the group summarising shared content and offering reflections and resources relevant for all supervisees.
If any session extend beyond 50 minutes, additional time will be charged in 10-minute increments at a pro-rata rate of $220 + GST per hour.
All ongoing supervisees have access to occasional, brief support between sessions via email or phone. This is offered to help maintain momentum and provide timely support for emerging questions or challenges.

TYPE OF SUPERVISION REQUESTED

I would like the following type of supervision *

Individual Joint (2 people)Group (3-4 people)

PAYMENT TERMS

I agree to pay my invoice within 7 calendar days of the issuing of the invoice. I acknowledge that I will be sent a late payment admin fee of $10 and supervision services will be put on hold if I have an overdue invoice. *

Yes

USE OF TECHNOLOGY

Kimmy uses Zoom for supervisions session and Heidi Health to support notetaking. Your supervision notes will be securely stored in the Be You Occupational Therapy Pty Ltd client management system (Nookal). From time-to-time Kimmy might use de-identified information to generate resources in ChatGTP.

CONFIDENTIALITY

Kimmy will uphold the confidentiality of matters discussed during supervision, unless she becomes aware of information related to issues of safety for you or others. In all other situations, Kimmy will obtain your written consent prior to sharing details of your supervision sessions with them.

EVALUATION OF SUPERVISION

Informal evaluation of supervision will occur as an ongoing process during our supervision relationship. A formal evaluation may take place periodically if you request this.

SUPERVISORY RELATIONSHIP

The supervisory relationship is key to beneficial supervision. In the unlikely instance of a conflict in our relationship, both of us will take every effort at the earliest opportunity to resolve this. In situations where a resolution is not possible, we may agree that you transition to another supervisor.

Supervisor Responsibilities

uphold the professional values that support professional relationships
use models and approaches that ensure professional supervision is holistic and effective
provide honest and developmental feedback
share knowledge and resources that may be of benefit
review and reflect on each supervision session
maintain confidentiality
send the supervisee supervision notes

Supervisee Responsibilities

uphold the professional values that support professional relationships
optimally engage in reflection, analysis and action
be open to making changes in clinical practice
reliably follow up on agreed actions
prepare an agenda for each session and submit this to Kimmy at least 24 hours prior to the scheduled session
make your own supervision notes, where appropriate

Invoicing

Payer full name *

Payer email *

Payer phone number *

Supervisee Agreement

By signing this agreement, you commit to fostering a supportive, constructive and professional environment conducive to your continued growth and development. You also agree to the terms noted within this supervision agreement.

Date signed *

Supervisee signature *

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Supervisor Agreement

By signing this agreement, the supervisor commits to fostering a supportive, constructive and professional environment conducive to the continued growth and development of the supervisee. You also agree to the terms within this supervision agreement.

Date

Supervisor signature

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