Upon request, can you provide proof and copies of your provincial licensure or registration?
Which regulatory college are you a registrant of?
Ontario Clinical Requirements
Have you completed 30 hours of directed learning in providing clinical supervision?
Please indicate your directed learning activities:
Select all that apply
Do you understand CRPO’s definitions of clinical supervision, clinical supervisor and the scope of practice of psychotherapy?
I acknowledge that I will not agree to provide supervision to practicum students in circumstances that may form a dual relationship with the supervisee as outlined in the Supervisor Practicum guide (i.e., where I am the practicum student's direct employment supervisor, friend, therapist/counsellor, teacher, etc.)
I agree to uphold the requirements and procedures outlined in the Supervisors Practicum Guide.
I understand that all potential supervisors are required to provide a copy of (1) current CV or Resume and (2) registration/certification/licensure document to be reviewed and approved by the Department of Field Training, even if they have provided it previously. Please email these items to our Practicum Liaison [email protected]
in order to complete the application process.