JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Practice Manager Application
Thank you for taking the time to apply for a position with Attunement Counseling & Wellness Collective! We will review your application and reach out to schedule an interview if your qualifications are a good fit.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Full legal name
*
Your answer
Date of birth
*
Your answer
Address
*
Your answer
Email address
*
Your answer
Are you available between the hours of 9:30-4:30 Monday through Friday?
*
Yes
No
Have you ever worked for a mental health practice before? Please provide the names of the practices and dates of employment if applicable.
*
Your answer
Have you ever worked in a customer service capacity before? Please provide your previous positions and dates of employment if applicable.
*
Your answer
Please comment on your familiarity with medical billing and coding, specifically with mental health CPT codes.
*
Your answer
What makes you the right person for this position?
*
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Attunement Counseling & Wellness Collective.
Report Abuse
Forms
