Mindspace Counseling Employment Questionnaire
Thanks for taking the time to apply for a therapist position at Mindspace Counseling. To streamline the process and be sure we are an appropriate match, please fill out this questionnaire. Thank you!
Sign in to Google to save your progress. Learn more
Your Name *
Email *
Your phone number *
What is your licensure status? *
If provisionally licensed, when do you anticipate full licensure? *
Please tell us about your specialty/niche(s). List any certifications, previous experience, or any other information that informs us about your ability to work with that population(s). *
Who is your ideal client? *
What is your ideal schedule? *
Do you have previous private practice experience? *
Mindspace Counseling brings on therapists who can commit to working solely at MC. We value work-life balance for our team who can be more invested in our culture and mission. Will you be working in your own private practice or at another group practice or agency if employed at MC? *
How did you hear about us? *
Thank you for taking the time to respond. We will reach out shortly.
If you haven't already, please email your resume and cover letter to career@mindspacecounseling.comĀ 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mindspace Counseling, PLLC. Report Abuse