As a Licensed Clinical Professional Counselor in supervisory standing in the State of Kansas, I provide clinical supervision to Licensed Professional Counselors (LPC) working towards their clinical licensure. If you are in need of a clinical supervisor and feel that I may be a good fit, please contact me by telephone, email, or the form below so that we can discuss your training plan, theoretical orientation, scheduling, and rates.
In addition, I am a Registered Play Therapist-Supervisor (RPT-S) providing supervision for clinicians working towards their RPT. If you are in need of a RPT-S and feel that I may be a good fit, please contact me by telephone, email, or the form below so that we can discuss your theoretical orientation, scheduling, and rates.
Policies & Rights
- You have the right to: be informed of your Supervisor’s qualifications including his or her background, license, registration, areas of training, level of competency, play therapy specialization, training and years practicing as a supervisor. You also have the right to be informed of the supervisory procedures and risks; your supervisor’s professional limitations; request a referral for a second opinion; participate in supervision planning/review/revision as well as terminating supervision at any time with a request for referral if desired.
- You have the right to supervision confidentiality. Information may not be revealed to anyone without written permission from you except when disclosure is required by law, as in the following circumstances: suspicion of child abuse, neglect, sexual abuse, or abuse of a senior citizen; suspicion that the client presents a danger by having a plan to hurt himself or someone else; when disclosure may be required pursuant to a legal proceeding
- EMERGENCY PROCEDURES: For after hour emergencies call 911. Urgent calls can be made to Mrs. Petrik on her cell phone which will be provided to you after the supervision contract has been signed, or 785-477-9117 which is her Private Practice. Please use this number for extreme urgencies. If you do not hear back from Mrs. Petrik within 5 minutes, call 911.
- RECORDS: I understand that supervisee records are destroyed after 7 years of inactivity. I understand that in the following circumstances, retirement, transfer or her sudden incapacity or death, I will be notified by either Mrs. Petrik or her Emergency Response Team regarding the protocol for my transfer of supervision and disposition of supervisory records. Public notice, print or electronic, may be used in the event of her death. If supervisory records change location, for any reason, I understand that a good faith effort will be made to notify the supervisee of the specific change and instruction will be given in how to access records. I understand supervisees may request a transcript, synopsis or copy of their case notes through a written request to Mrs. Petrik. It is my responsibility to keep Mrs. Petrik informed of any of my address or phone number changes. I understand that there is a usual and customary charge for chart retrieval, chart review, copying of records and a one on one meeting with Mrs. Petrik. It is required that I meet with Mrs. Petrik to review the records prior to personal receipt of treatment notes. I will be charged accordingly for this service.
- LOGS: I understand that both my supervisor and myself will track my hours of supervision to determine when I have met the appropriate hours for my Training Plan. I will track my client contact and clinical hours and provide those logs for my supervisor for review.
- PRACTICE NOTICE: Amanda Petrik, LCPC, RPT-S, may, at times, be affiliated with other health professionals who have joined together for the purpose of sharing a facility or securing peer consultation. If so, each health professional maintains their own private practice and in no way assumes any responsibility for the practices of the other full or part time professionals working out of this office or for professional considerations secured in the context of peer consultation.
- SCHEDULING: I understand that it is my responsibility to contact Mrs. Petrik to schedule and/or reschedule supervision services. To maintain this supervisory relationship, I am required to been seen at least twice per month. Please cancel in a timely manner, which is considered 24 hour notice, however emergencies are understood and will be discussed.
- PAYMENT: Payments can be made in the form of cash, check, or credit card. Please call for supervision rates; payment is expected at the time of supervision. If payments are not made in a timely manner, a credit card number will be kept on file and charged for you.