employment application
Candidate Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Position you're applying for
*
Please Select
Licensed Psychologist (Ph.D. / Psy.D.)
Psychological Associate / Assistant (Postdoc)
Psychological Associate / Assistant (Predoc)
Psychotherapist (Associate)
Psychotherapist (Licensed)
Psychiatrist
Psychiatric PA
Nurse Practitioner
Administrative Assistant
Intern
Licensed as
*
Please Select
Licensed Ph.D.
Licensed Psy.D.
LMFT
LCSW
LPCC
---
Predoctoral Psy.D.
Predoctoral Ph.D.
Postdoctoral Psy.D.
Postdoctoral Ph.D.
AMFT
ASW
APCC
---
MD
DO
---
N/A
License / Associate / PSB Number
*
If not applicable, please write "NA"
Clinician Questionnaire
If you are applying for a licensed or pre-licensed clinical position, please complete the following. All others: jump to CV/Resume.
Are you currently licensed (or registered) to practice in California?
Yes
No
What age groups are you experiences with and open to treating?
Children
Adolescents
Adults
Geriatrics
Are you seeking to work in-person (San Diego), a hybrid model, or completely remote?
In Person
Hybrid
Remote
Are you seeking a part-time or full-time caseload?
Full-time (28+ clinical hours / week)
Part-time (15+ clinical hours / week)
Start off part-time and later move to full-time
Estimated start date
-
Month
-
Day
Year
Licensed clinicians: it could take 30-90 days for insurance credentialing. Associate clinicians: it could take 30-60 days for supervision agreement.
Specialties and/or areas of experience or expertise
ADHD - Adults
Anxiety, Stress, Panic Disorders
Autism - Adult
Autism - Children
Children/Adolesents
Chronic Pain
CBT
Crisis Intervention
DBT
Depression, MDD
Domestic Violence
Eating Disorders
EFT
ERP
EMDR
Family Therapy
Gender/Transgender Identity Issues
Grief and Loss
LGBTQ+ Issues
Men's Issues
Military and Military Families
Mood Disorders
Multicultural Issues
Neuropsychological Assessment
OCD
Personality Disorders
Phobias
PTSD
Post-partum, Pregnancy, Maternal
Psych Testing
Psychotic Disorders
Sleeping Disorders
Substance Use Disorders
Tourette's Syndrome
Women's Issues
Provide some insight into your background, including any certifications or specialized training or experience, that can enhance our Ohana's multi-specialty group.
Anything else we should know about you?
Your CV/Resume (as a PDF)
*
Browse Files
Drag and drop files here
Choose a file
Note: you will be asked to provide THREE (3) PROFESSIONAL REFERENCES and a SAMPLE OF YOUR REPORT WRITING
Cancel
of
Submit
Should be Empty: