|
Thank
you for visiting this site to register interest in receiving online supervision
for your clinical practice. You can indicate below whether your main interest
is in supervision for online or face-to-face work, say what sort of clinical practice
you are involved in, list the facilities you are interested in an online supervision
group using and select various other preferences regarding the type of group you
wish to join. The intention is to group you, as far as possible, together with
other participants, according to your preferences. Once you have completed the
form you can submit it by clicking the 'submit' button at the bottom of this page.
You will be e-mailed shortly afterwards with confirmation that your form has been
received. 
<%
If request.querystring("Error")= "NoUsername" Then
Response.Write "
Please ensure you complete the 'Username' field below"
End If
If request.querystring("Error")= "NoPassword" Then
Response.Write "Please ensure you complete the 'Password' field below"
End If
If request.querystring("Error")= "NonMatchingPasswords" Then
Response.Write "Please ensure you type exactly the same characters into the two 'Password' fields below"
End If
If request.querystring("Error")= "BadPassword" Then
Response.Write "You already have a password from a previous registration with the online-supervision site or with GroupInterVisual. Please ensure you type your correct password into the two 'Password' fields below."
End If
If request.querystring("Error")= "SecondUsername" Then
Response.Write "You already have a username from a previous registration with the online-supervision site or with GroupInterVisual. Please ensure you type your correct username into the 'Username' field below."
End If
If request.querystring("Error")= "Dupeusername" Then
Response.Write "Sorry - the username you chose ' " & Session("username") & " ' is already taken! Please select another username."
End If
Session("GivCookieTest") = Request.Querystring("GivCookieTest")
If Session("GivCookieTest") = "" Then
GivCookieTestBounceURL = "http://www.groupintervisual.net/asp/alienCookieTest.asp?Referral=www.online-supervision.net/asp/SuperviseeRegistration.asp"
response.redirect GivCookieTestBounceURL
End If
Session("GivCustomerID") = Request.Querystring("GivCustomerID")
If Session("GivCustomerID") = "" Then
If Request.Cookies("OLS").HasKeys Then
Session("GivCustomerID")= Request.Cookies("OLS")("GivCustomerID")
End If
End If
Set conn = Server.CreateObject("ADODB.Connection")
conn.Open connstr
If Session("GivCustomerID") <> "" Then
strSQL = "SELECT Username, Title, Password, FirstName,"
strSQL = strSQL & " LastName, EmailAddress,"
strSQL = strSQL & " StreetAddress1, StreetAddress2, Town,"
strSQL = strSQL & " County, Country, PostCode, TelephoneNo"
strSQL = strSQL & " FROM Customers"
strSQL = strSQL & " WHERE CustomerID = '" & Session("GivCustomerID") & "'"
Set rs = conn.Execute(strSQL)
Session("username") = rs.Fields("Username")
Session("password") = rs.Fields("password")
Session("title") = rs.Fields("Title")
Session("firstname") = rs.Fields("Firstname")
Session("lastname") = rs.Fields("Lastname")
Session("emailaddress") = rs.Fields("EmailAddress")
Session("address1") = rs.Fields("StreetAddress1")
Session("address2") = rs.Fields("StreetAddress2")
Session("town") = rs.Fields("Town")
Session("county") = rs.Fields("County")
Session("country") = rs.Fields("Country")
Session("postcode") = rs.Fields("PostCode")
Session("telephone") = rs.Fields("TelephoneNo")
rs.Close ' Close recordset
Set rs = nothing ' Remove recordset
End If
%> |
| profession
|
| | I
am interested in the possibility of
receiving online
supervision mainly in connection with my clinical practice in the field of:
|
|
| | My
orientation is:
|
|
| | My
years of experience in this field total around |
|
|
| I
am mainly interested in receiving supervision for my face-to-face clinical
work. | <%
Response.write ""
%> |
I
am mainly interested in receiving supervision for my online clinical work. |
<%
Response.write ""
%> |
| |
| I
envisage an ideal online supervision group as having a structure like this:
|
| |
|
size
of group membership |
|
| |
I
am only interested in one-to-one supervision |
<%
Response.write ""
%> |
| |
Ideally,
I see the minimum number of members as |
">
|
|
| Ideally,
I see the maximum number of members as |
">
|
|
|
| method
of online interaction
|
|
| Ideally,
I would like the following facilities regularly used by the group |
| |
|
| |
A
restricted membership, private, e-mail discussion group |
<%
Response.write ""
%> |
|
|
Private
(password protected) online archives of forum messsages |
<%
Response.write ""
%> |
|
|
An
private Instant Message conference facility |
<%
Response.write ""
%> |
| |
A
private (password protected) file storage area |
<%
Response.write ""
%> |
|
|
A
private videoconference facility |
<%
Response.write ""
%> |
My
years of experience of Internet use amount to
|
|
| |
|
| |
|
|
I would describe the sort of arrangement I am looking for as |
| | |
| | a
free-flowing exchange with people offering feedback to each other as and when |
<%
Response.write ""
%> |
| |
an
active, task-focused group with a set time committment from members |
<%
Response.write ""
%> |
| |
The
hours I anticipate wanting to commit to online supervision per week would be in
the region of: |
|
| | |
| charges | |
| Early
registrants intending to access supervision who are willing to participate in
the research project and offer feedback in developing and fine-tuning the system
are being offered the opportunity for the time being to access supervision from
world class supervisors for free. A small contribution of £42 for the first
year will be required towards the cost of setting up the facilities and software
development, however, for which secure, online credit card payment facilities
are available. At the end of the first year's research project, those who have
participatedwill get priority in any special offers available once all supervsion
services are on a fee paying basis. |
| |
| |
I
would be willing to contribute £42 towards the first year set-up costs of
the online supervision system. | |
| |
I
would not be willing to pay anything for this facility. |
|
|
|
| leadership |
| Please
indicate your preference for peer group supervision or a supervisor-led group.
|
| |
I
would prefer peer-group supervision.
|
|
| |
I
would prefer to join a supervisor-led supervision group (and after the first year
of free supervision would be willing to pay an extra monthly fee to the supervisor
for this service). | |
|
|
| research |
| The
intention is to undertake some research to establish participants' views of the
value and optimum structure of online supervision facilities. Participants may
therefore be interviewed or invited to complete online questionnaires such as
this one, during the course of their participation, with a view to publishing
an account of the experiment. The understanding would be that no one's responses
would be quoted without their express permission. Are you willing to participate
in this?
|
|
I
would be willing to take part in this research |
<%
Response.write ""
%> |
|
I
would not be willing to participate in this research. |
<%
Response.write ""
%> |
| |
| personal
details |
| |
Title |
|
|
|
First
Name |
">
|
|
| Surname |
">
|
|
|
Address |
">
|
|
|
|
">
|
|
|
Town |
">
|
|
|
County |
">
|
|
|
Country |
">
|
|
|
Post
Code |
">
|
|
|
E-mail |
">
|
| |
|
| Telephone |
">
|
|
|
How
did you hear about GroupInterVisual's online supervision groups? |
|
| |
| comments
|
|
Please
use the space below to make any comments you would like us to read, either regarding
your expectations for online group supervision, or about this form, or about anything
else. |
| |
And
finally... We
need you to choose a username and password to uniquely identify you when you return
to this site either for supervision purposes or to participate in the research.
|
|
Thank
you for completing this form. Please now press submit, and your details will automatically
be entered onto our database. You will receive a confirmation e-mail at the address
you have submitted, and will hear further in due course. |
| |
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