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Lived & Living Experience Supervisor application form

Share your Lived and Living Experience expertise by joining the Collaborative Centre's supervisor database

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Minimum criteria

* indicates a required field

Details

First name is required.

The text you enter in the above text box will show on your public listing

Last name is required.

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Email address is required.

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Where do you live is required.
Phone number is required.

Mobile or landline, please include area code. The purpose of collecting your phone number is for the database managers to contact you if necessary.

The text you enter in the above text box will show on your public listingMobile or landline, please include area code

Perspective/discipline is required.
minutes

The text you enter in the above text box will show on your public listingPlease write this in minutes, for example one-and-a-quarter hours is 75 minutes.

$ Dollars

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The text you enter in the above text box will show on your public listing.

Experience

About me is required.

The text you enter in the above text box will show on your public listing Please describe in a paragraph or two, your background. This is the first information that people will read about you, providing a broader or more personal overview such as: what interests you, your values, previous life experience, work history outside of lived experience, languages spoken, diversity etc.

My experience is required.

The text you enter in the above text box will show on your public listing Minimum 2 years in a designated consumer or family/carer role is required List here designated consumer or family/carer roles you have previously held. This will assist supervisees to determine if you have had the experience that is relevant to them. This may include role title, organisation, clinical or non-clinical sector, any other important characteristics of the roles (e.g. first peer support worker in the service).

The text you enter in the above text box will show on your public listing It is optional to provide this information. Filling out this section may give potential supervisees confidence in the currency of your knowledge and experience and relevance to their work. It may also assist in determining any conflicts of interest if you are working for the same organisation.

My training is required.

The text you enter in the above text box will show on your public listing Specify any relevant training you have engaged in. This will assist supervisees to choose a supervisor who has a compatible approach.

Services or settings I have experience inYour response below will show on your public listing. Select as many as apply.
Do you supervise from an intersectional lens? If yes, please indicate relevant experienceYour response below will show on your public listing. Select as many as apply.
My approach to supervision is required.

The text you enter in the above text box will show on your public listing Describe in a short paragraph or two the approach you take towards supervision, your values as a supervisor, any methods or tools you use, why you are offering this service, what motivates you and what you aim to provide. Include any other information that will assist the supervisee to determine a suitable match.

Availability and delivery

Please indicate any of your specialty areasYour response above will show on your public listingSelect as many as apply.
Do you have experience in providing group supervision? *
Please indicate if you have experience providing group supervision.
What format of supervision do you provide? *Your response above will show on your public listing
Please select at least one supervision format.
What frequency of supervision can you provide? *Your response above will show on your public listingTick as many as apply
Please select at least one supervision frequency.
Mode of delivery *Your response above will show on your public listingSelect all that you are able to accommodate.
Please select at least one mode of delivery.

The text you enter in the above text box will show on your public listing Please list a few suburbs or the general area/region you practice in.

AvailabilityChoose whole days or parts of days. Press the + sign to select parts of days

The text you enter in the above text box will show on your public listing

Consent

You must consent for your public information to be made available.
You must confirm you have capacity to provide supervision.
You must agree to receive supervisor database communications.