Fillable Form

Weekly Associate Notes and Topics for Discussion

Weekly self-report completed ahead of each supervision session.

Week Overview

Associate Name

Week Of

Direct Client Hours This Week

Indirect Hours This Week

Number of Clients Seen

List cases (by initials or case number only — no identifying information) you'd like to discuss in supervision.

Case 1 — Presenting Concern / Question for Supervisor

Case 2 — Presenting Concern / Question for Supervisor

Case 3 — Presenting Concern / Question for Supervisor

Ethical or Legal Questions

Personal Reflection / Self-Care Note