a handbook for supervising allied health professionals - HETI - NSW ...

Appendix E
Supervision feedback form example
This form is designed to help you, your team and the service as a whole to get the most
from your clinical supervision.
Frequency of supervision sessions:
____________________________________________________________________________
Do you have an agreed documented supervision contract with your supervisor Yes / No
Are your supervision goals and objectives being met
Yes / No
In what way are / aren’t these goals and objectives being met
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
What are the most useful aspects of your supervision
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
What expectations are not met from your supervision
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Do you have any additional comments about your supervision
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Source: Area Nursing and Midwifery Services Policies and Procedures, Clinical Supervision Policy 2007/01
cited in South Eastern Sydney Illawarra area procedure, Clinical Supervision – Podiatrists, September 2008.
SECOND EDITION
HETI
THE SUPERGUIDE
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