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Clinical Supervision Session Form - Arizona Board of Behavioral ... - azbbhe 2026

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The document is a Clinical Supervision Session Form used to record details of supervision sessions between a supervisor and supervisee. It includes sections for session logistics, topics discussed, compliance review results, potential conflicts of interest, and signatures from both parties. The form emphasizes adherence to legal and ethical standards in clinical practice and outlines minimum elements that must be addressed during supervision, ensuring safe and competent service delivery.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the name of the supervisee and the date of the session at the top of the form.
Select the mode of session (Online, Telephone, Telemedicine, or In person) and indicate whether it was an Individual or Group session.
Fill in the duration of the session and specify the mode of clinical oversight. Remember that telephonic sessions must be at least 30 minutes.
Provide a comprehensive description of topics discussed during the session and results from compliance review of clinical documentation.
Indicate if any conflicts of interest exist between supervisor and supervisee, as well as between supervisee and clients by checking 'Yes' or 'No'.
Complete all sections thoroughly as required. Enter supervisor’s name, credentials, telephone number, and obtain signatures from both supervisor and supervisee along with dates signed.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How many hours of supervision for LCSW in Arizona?

Of the minimum 100 hours of clinical supervision required for licensure, the Board may accept: a. Up to 75 of the clinical supervision hours involving a group of two supervisees, and b. Up to 50 of the clinical supervision hours involving a group of three to six supervisees.

What are the rights of mental health patients in Arizona?

The right to participate in all phases of your mental health treatment, including individual service plan (ISP) meetings; The right to a discharge plan upon discharge from a hospital; The right to consent to or refuse treatment (except in an emergency or by court order);

Who regulates assisted living facilities in Arizona?

The Division of Public Health Licensing Services, Bureau of Residential Facilities Licensing, licenses assisted living facilities (ALFs).

What is a level 1 behavioral health facility in Arizona?

Level one behavioral health facility means a behavioral health service agency that is licensed by the department of health services and that provides a structured treatment setting with twenty-four hour a day supervision and an intensive treatment program.

Is clinical supervision a disciplined tutorial process?

Clinical supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive (Powell Brodsky, 2004, p. 11).

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Who regulates mental health facilities in Arizona?

ADHS was established to protect the physical and mental health of Arizona citizens and to promote the highest standards for licensed healthcare institutions, emergency services, and care facilities for adults and children. Agency responsibilities have changed somewhat since its creation.

How do you structure clinical supervision?

The Typical Structure of Clinical Supervision Sessions The structure may include: Case Presentations: Supervisees present cases they are currently working on, providing detailed information about the client, assessment, treatment goals, interventions used, and outcomes.

How do I file a complaint against a mental health facility in Arizona?

with a Serious Mental Illness (SMI) If you continue to have questions or difficulties accessing services, please call AHCCCS Clinical Resolution Unit at 602-364-4558 or 1-800-867-5808 or submit concerns about quality of care by email at CQM@azahcccs.gov.