Therapist Questionnaire for Group Sessions.

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We appreciate your interest to assist in our group sessions! These group sessions help our community to feel more supported in their everyday life and we couldn't do this without you!

Our mission is to provide a space where they can feel supported, seen and given tools to live life on purpose and cultivate happiness for themselves. We envision discussions around important topics that our community struggle with like emotions, neglect, trauma, self love and more that tend to hold them back from living a emotionally healthy lifestyle.

We would love to have you join the team for a great cause.

Below are questions to get an idea of how you operate, your interests, and what you are able and willing to assist us with.

After submitting your questionnaire, we will:
1. Review everything and contact you with any questions we may have.
2. Add you to our email list for upcoming group sessions for you to sign up for a slot.

Please answer all questions, if it does not apply to you, put "N/A"

We thank you for your time and we are looking forward to hearing all about you!

Email *

First and Last Name *

Certification Title(s): *

Please note that we are a non profit and we aim to help the community of people with resources to live an authentic life on purpose that brings them peace. We do this through the help of community professionals, donations, volunteers, resources, active programs, etc. Please select one below. Thank you for your desire to help the community grow mentally and emotionally! *

I understand. I would love to contribute my help for free.

I understand. I would love to contribute my help for a discounted rate.

I understand. I would love to contribute my help at my full rate.

Other:

Phone Number *

Name of Practice, if any. *

What is the number of years you’ve actively worked as a therapist? *

Do you currently offer or administer group therapy? Click all that apply below: *

Yes, to youth

Yes, to kids

Other:

Required

Do you currently provide virtual therapy to clients? *

Yes

I am comfortable speaking with (check all that apply): *

Adults

Young Adults

Kids

LGBTQ+

Other:

Required

Our group discussions focus on helping women live intentionally and internally happy. Please list some topics you are comfortable speaking on below: (examples: Mental Health, Self Love, Finding purpose, How to love themselves first, Boundaries, How to cultivate true internal happiness, etc.) *

What is your availability to administer a 1 hour group session on a specific topic? Click all that apply *

Weekends in the evening

Once a Month

Twice a year

Once a year

Weekdays in the evening

I am open to any time

Other:

Required

Would you like to be added to our database of trusted therapists for direct contact for services? *

Yes

Other:

What would be an acceptable rate for you to administer a 1 hour Group Discussion with our non profit? *

What would be an acceptable rate for you to provide a Happi Girl member with one-on-one therapy? Rate will be paid by Non Profit. *

Do you have any additional comments, group topic suggestions or anything else you would like for us to know about you?

Send me a copy of my responses.

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