• Initial Screening Form

    (Sliding Scale Request) Psychology interns or practicum students provide therapeutic services to clients under the supervision of a licensed provider (e.g., licensed psychologist, licensed professional counselor). These students are generally in the process of completing their Master's or Doctorate Degree, and are in need of supervised clinical experiences to fulfill licensing requirements​For clients, this means that you will be working with a supervisee, and your case will be supervised by a staff therapist. Ultimately, you have an extra set of eyes reviewing  your clinical work, to ensure that you are receiving the most relevant and up-to-date care. Because the supervisees are in training, services are offered at a lower cost to clients. ​If you are interested in working with a supervised clinician, please complete the following form, and someone from the office will be in touch.
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    Pick a Date

  • By SUBMITTING THIS FORM, you agree to the following:
    1) I give Alpine's Empowerment Agency permission to follow-up with you via call or email to discuss your needs further. 

     

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