What is your primary Licensure or area of expertise? In what year were you initially licensed? Are you currently credentialed with any insurance companies?
How many years of experience do you have treating patients in an outpatient psychotherapy setting? How many patients would you desire to see per week? How many years of experience do you have treating patients in an outpatient psychotherapy setting? What are your preferred areas of specialization or interest? (Check all that apply).
Are you looking to transfer patients from another practice?
What treatment approaches or theory drives your clinical interventions and why?
How would you describe yourself as a therapist?
How would you prefer to meet with patients? Are you willing to work at least two evenings (5p-9p) a week?
Are you willing to work on the weekends?
Why are you interested in working with Simply Mindful Counseling?
Please submit at least two work or academic related references.
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