Supervision Log & Review Packet
One packet to bring to clinical supervision — a title page, a per-client review log, a documentation checklist, and an administrative page with supervised-hours tracking and sign-off. Print the whole thing with one button; each section starts on its own page.
Meridian Mental Health
Supervision Log & Review Packet
A structured place to prepare for clinical supervision — client review, documentation, and administrative tracking, together in one packet.
Clinician
Credential / license (or license track)
Clinical supervisor
Supervisor credential / license
Agency / practice setting
Program or team
Supervision period — from
to
Date prepared
How to use this packet
- • Photocopy the Client supervision review page once for each client you plan to discuss.
- • Use initials or a case/ID number only. This packet is designed to hold no client-identifying information — never write a full name, date of birth, or address.
- • Complete by hand and keep the finished pages with your supervision record.
- • Prints black-and-white; no meaning is carried by color, so photocopies stay legible.
1 · Client supervision review
One client per page — photocopy this page for each client reviewed. Identify the client by initials or a case number only. No full names, DOB, or other identifying details.
Client (initials / case #)
Date of this review
Presenting concern & current focus of treatment
Risk & safety flags this period
- Suicidal ideation raised / present
- Risk of harm to others raised
- Safety plan reviewed or updated
- Higher level of care considered
- Mandated report considered / filed
- Substance-use concern this period
- Abuse / neglect concern
- No acute safety concern this period
Interventions & plan since last supervision
Progress & client response
Questions / cases to bring to supervisor
Action items & follow-up before next session
2 · Paperwork & documentation review
A quick sweep of the record-keeping that keeps care compliant. Check what’s current; note what’s outstanding.
Current & complete
- Progress notes current — none open or unsigned
- Treatment plans current and signed
- Treatment-plan reviews / updates on schedule
- Consents & releases (ROIs) on file and unexpired
- Diagnoses & problem lists up to date
- Measures / outcome scores recorded
- Coordination-of-care notes filed
- Intake / assessment paperwork complete
Billing & coding
- Session codes (CPT) match documentation
- Diagnosis (ICD-10) codes current
- Authorizations / units remaining checked
- Superbills / claims up to date
Documentation questions for supervisor
Outstanding documentation to complete (with due dates)
3 · Administrative review
Supervision date
Next supervision date
Format (individual / group / dyadic)
Frequency (e.g. weekly)
Supervised hours (toward NH social-work licensure)
Track supervised hours toward the NH LICSW path. Confirm current hour categories and totals with the New Hampshire Board of Mental Health Practice and NASW–NH.
Direct client-contact hours this period
Individual supervision hours
Group supervision hours
Other supervised hours
Cumulative hours to date
Target / hours remaining
Caseload review
Current caseload size
New intakes this period
Discharges / terminations
Waitlist / pending referrals
Caseload concerns, capacity, or balance to discuss
Scheduling & professional development
Scheduling, PTO, and coverage
Trainings, CE, and professional-development goals
Reflection
One thing that went well this period
One thing I felt stuck on — and what would help
Focus for the next period / next sessions
Sign-off
Clinician signature
Date
Supervisor signature
Date
Meridian does not collect client-identifying information. Complete this packet by hand and retain it with your supervision record. This is a practice-support tool, not legal or licensure advice — confirm supervision and documentation requirements with your supervisor, your agency, and the NH Board of Mental Health Practice. Content last reviewed July 2026.