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Case Report Worksheet
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Please answer each of the items on the form below. Certain cases will be adapted for use in training.
If your case is selected for use, you will be contacted for your permission to use it and, if permission
is given, for more details. The case prepared for fi nal use will be written so that all people involved,
including yourself, will be anonymous.
Name: __________________________________ Work phone: ___________________
Describe a challenging situation you have faced or are currently facing as a supervisor. There are
several reasons why the situation may be challenging:
• It was unusual.
• Even though it was unusual, you were not sure what to do about it.
• The demands or conditions were complicated.
There could be other ...