Legacy Wellness Services Contractor Interest Form
Legacy Wellness Services serves Black women in need of quality care. We have traditionally focused on mental health services but are looking to branch out due to the lack of quality services available to our community. We are currently looking for Fully Licensed Part-Time Contractors (Licensing does not apply to coaches). If you are looking for a safe place to provide care through a decolonized lens we want to hear from you. 

We are also interested in working with Practitioners who no longer want to own a private practice. We are willing to help you transfer clients to our organization and pay you a set rate based on sessions (and notes) completed. However, you are welcome to continue working in your own practice.

We do not accept insurance but we do accept vouchers from Loveland Foundation and Black Girls Smile.

Here are a few responsibilites expected of Legacy Wellness Services and Contractors:

Legacy Wellness Services Responsibilities:
  1. Billing.
  2. Marketing.
  3. Pay contractors on time.
  4. Quality Assurance for clients.
  5. Verify credentialing and licensing.
  6. Facilitate communication and collaboration between contract workers and other staff members.
Contractor Responsibilities:
  1. Complete Progress Notes in a timely manner.
  2. Provide treatment from a decolonized lens.
  3. Assessments and possible diagnoses.
  4. Continuing Education.
  5. Treatment planning.
  6. Confidentiality.
If you have any questions please send them to nicole@legacywellnessservices.com

*Please note that completing this Interest Form does not serve as a contract between you and Legacy Wellness Services.

**Please also note that this a contractor position.
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Email *
What is your first and last name? *
What are your pronouns? *
What is your phone number? *
Is it better to contact you by phone or email? *
What services are you interested in providing to clients? *
Required
What areas do you specialize in? (Check all that apply) *
Required
Are you trained or certified in any treatment modalities?
What states are you licensed in? If your role does not require a license, please list the areas where most of your clients reside. *
What is your desired pay rate per session? Please include how long sessions typically occur for services (30 minutes, 45-60 minutes, 90 minutes, etc.)

*
How many clients would you like to see weekly? *
What is your desired schedule like? *
Required
What are you looking for when choosing an organization to work with?
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