Cicero Therapies Clinical Team Member Application
  • Cicero Therapies

    Clinical Position Application
  • Are you ready to help children thrive?

    We are excited to start this process with you!
    Complete this application below, and we will be in touch soon.

    Have a question? Email careers@cicerotherapies.com

  • Format: (000) 000-0000.
  • How did you hear about Cicero Therapies?*
  • Which practice location are you applying?
  • Which clinical position are you applying?
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  • Demographic Information

  • Which of the following describes your gender?*
  • How would you describe your race/ethnicity?*
  • For government reporting purposes, please indicate if you are a veteran.*
  • The following question is asked to comply with government regulations. Your response is voluntary. Do you have a physical or mental disability that substantially limits one or more major life activities?
  • Regulatory Questions

  • Are you legally authorized to work in the United States?*
  • Will you now or in the future require sponsorship for employment visa status?*
  • If hired, will you be able to provide proof of identity and employment eligibility as required by the federal government?*
  • Have you ever been convicted of a crime? (Applicants in IL or MA, please skip this question)
  • Do you hold any active professional licenses or certifications relevant to this position?*
  • Has your licensure ever been revoked or suspended?*
  • Have you ever been excluded from participation in Medicare, Medicaid, or any other federally funded healthcare program?*
  • Has your medical liability insurance ever been denied or cancelled?*
  • Are you familiar with HIPAA regulations and willing to complete training to ensure compliance with patient privacy laws?*
  • This position may require a background check and/or drug screening as a condition of employment. Are you willing to comply with these requirements?*
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