Private Practitioner Consultation Meeting

Private Practitioner Consultation Meeting

To participate, you must be a member of Gateway Wellness Associates (GWA) or a mental health professional in the St. Louis, MO area in private practice or planning a private practice. Meetings are bi-weekly, Mondays, from 11am-12pm, until May 19.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Topics I am interested in for this meeting:

Case formulationDifferential diagnosisLearning about different modalities of treatmentPrivate Practice MarketingThe business side of private practiceGrowing into a group practiceNetworkingStaying up to date on insurance codingOther
Choose all that apply*

I am a member at Gateway Wellness Associates (GWA)I have never attended one of these GWA Consult MeetingsI am not a GWA member, but I have attended one of these consult meetings in the past
We are so excited to meet you! Please tell us a few things so we can verify you as a mental health professional.
Are you in private practice?
Are you located within 100 miles of the St. Louis area?

YesNo
So we may verify that you are a mental health provider, please provide your website or Psychology Today profile link.
If you do not have a website or PT profile yet, please provide your professional license number.
This is a hybrid meeting. Are you attending via Zoom or in-person?*

ZoomIn-person
In Person Sign-Up

In-person meeting is located in Suite 555 of 1034 S. Brentwood Blvd. Please arrive a few minutes early. Late arrivals may get locked out. Do NOT sign up for a seat at the table if you do not intend to attend live as seating is limited.
In Person Sign-Up (Space Limited to 8)
Virtual Agreement:

This is a consultatioin meeting where sensitive information may be shared. To attend this meeting virtually, you must keep video on at all times and connect from a private space. The moderator will remove any participants who are clearly joining from a public place.

The Zoom link will be sent to you after your status as a mental health professional has been verified.
Virtual Sign-up (space limited to 15)
- Choose Your Own Adventure
  
  You can choose your level of commitment to these consult meetings. If you just want to network and consult once in a while, RSVP as needed (if space allows).
  
  If you are looking for a consistant consultation opportunity without having to sign up each time, then choose "save my spot". We ask that you only save a spot if you intend to attend bi-weekly and consistantly. When a clinician reaches 3 missed meetings, they will forfeit their reserved seat.
- Choose your level of commitment:*
  
  I will sign up and attend as neededSave my spot bi-weekly
- Please attest to confidentiality:*
  
  I agree to hold all consultation confident and not to use identifying information when discussing specific clients or client issues with fellow consult team members
- Should be Empty: