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First name
*
Last name
*
Email
*
How Many Years Clinical Experience
Less than 1 year
1-3 years
4-7 years
7+ Years
License(s) Held
LSW
LCSW
LPC
LCPC
LMFT
PsyD
PhD
Experience Working With Children Under the Age of 10:
Yes
No
Which Demographics Will You Work With:
Children Under 8
Children 8-12
Teenagers
Adults
Couples
Families
Do you hold any of the following certificates:
CADC
CCTS
CDBT
CCTP
CCSP
EMDR
Are you bringing a current caseload?
Yes
No
Do you have knowledge and experience with the following therapeutic modalities:
CBT
Strengths-based
Mindfulness
Solution-Focused
Are you willing to work a minimum 18 hours per week, including four afternoon and evenings?
Yes
No
Apply Now
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