Clinician Application Form
Street Address Line 2
State / Province
Postal / Zip Code
License designation and state
If multiple just enter each on its own line in the box. The bottom right corner of the box can be dragged with your mouse to make larger.
Do you require supervision? If yes how many hours remain?
Are you interested in offering hours :
What location(s) are you interested in offering hours out of?
Toledo (coming soon)
Western Hills (limited availability)
How many client facing hours are you wanting to offer every week?
If interested in hybrid (some in person, some teletherapy, let us know how many hours in office vs virtually)
Tell us more about you!
Upload a copy of your resume
How did you hear about us?
I have worked with a referral partner of Compass Point
A Current Clinician of Compass Point
Please let us know who told you about us so we can say thank you!
Which of our affiliate providers have you worked with?
Applicants who move forward in the hiring process to meet with a clinical director will be asked for 3 references. If you'd like to insert them below, it can speed up the hiring process.
Please put references name, relationship, job title, and phone number.
Are you on LinkedIn? Please share your URL so we can connect!
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