Therapist Application Form
If you are interested in joining our clinical team, please submit the following form with your resume and cover letter. We look forward to hearing from you!
Full Name
*
First Name
Last Name
E-mail
*
Phone Number
*
What is your current license type and license number?
*
(If license is pending, please describe your education level, licensure goals, and current timeline/status.)
What are your preferred treatment methods/modalities?
*
What populations/demographics do you feel comfortable working with?
*
What is your ideal work set-up? (weekly hours, ideal schedule, etc)
*
Is there anything else you'd like us to know?
*
Available start date:
*
/
Month
/
Day
Year
This can be approximate
Please upload your resume (and cover letter if available...)
Accepted file types: pdf, doc, docx, xls, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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