LCSW Supervision Inquiry

Supervision Inquiry Form

Please complete the following form for initiating contact with me about supervision. Before contacting me, please review the rules around clinical supervision and make sure you meet requirements for LCSW supervision. Those can be found by reading Texas Administrative Code RULE §781.402, Clinical Supervision for LCSW and Non-Clinical Supervision for Independent Practice Recognition.

Please note, I do not currently have openings for supervision in my practice, but I may be able to offer referrals.

Have you accrued any clinical hours with another supervisor/plan? If so, please describe how many and reason for seeking new supervisor: *

Not currently accepting new supervisees.

If you are seeking clinical work in Moonstone Counseling, please e-mail resume and letter of interest to carly@moonstonecounselingcenter.com