Followup Application

Followup Online Application

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Which position are you applying for? *

Name *

First

Last

Phone Number *

Email *

What is your desired amount of clinical hours per week? *

Less than 5 5-10 10-20 More than 20

What is your desired amount of pay per clinical hour? *

Less than $40 $40-$75 $75-$100 More than $100

Are you comfortable using an EHR (Electronic Health Record) system? *

Yes No I am open to learning.

Do you own a computer or tablet you can use for work purposes? *

Yes No I can purchase one in the future.

Do you carry malpractice insurance? *

Yes No I am willing to buy coverage in the future.

We are exclusively a fee-for-service practice and do not work with insurance. Are you willing to help promote your services to the community? *

Yes No I am willing to learn.

Are you comfortable counseling individuals of another faith, sexual orientation, race, and/or background? *

What is your approach for integrating faith into counseling? *

What training and licensure or certification in counseling have you received? *

What formal theological training have you received? *

What do you enjoy the most about being a counselor? *

What is your personal testimony or faith journey? *

When are you available to start? *

Submit

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(480)525-7284

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How to Know If You Need Counseling

Scripture quotations marked (NIV) are taken from the Holy Bible, New International Version®, NIV®. Copyright © 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission of Zondervan. All rights reserved worldwide. www.zondervan.com The “NIV” and “New International Version” are trademarks registered in the United States Patent and Trademark Office by Biblica, Inc.™ Scripture quotations marked (NLT) are taken from the Holy Bible, New Living Translation, copyright ©1996, 2004, 2015 by Tyndale House Foundation. Used by permission of Tyndale House Publishers, Inc., Carol Stream, Illinois 60188. All rights reserved.

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Followup Online Application

Contact Us

(480)525-7284

Email Us

Book Now

How to Know If You Need Counseling