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Guiding Insight Employment Application
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone Number
*
Your answer
Licensure
*
LCSW-C
LCPC
LMSW
LGPC
Other:
Do you need clinical supervision hours
*
Yes
No
Theoretical framework you use as a therapist
*
Your answer
What are your strengths as a therapist?
*
Your answer
In what areas are you looking to grow as a therapist?
*
Your answer
What is your clinical area of interests? (anxiety; life transitions, LGBTQIA+, trauma, etc.)
*
Your answer
What age groups do you prefer?
*
Children (3 - 12)
Younger adolescents (13 - 15)
Older adolescents (16 - 18)
New adults (18 - 25)
Adults (26 - 64)
Older adults (65+)
Required
Relevant work experience (agency, length of time employed, brief description of job responsibilities)
*
Your answer
Relevant work experience (agency, length of time employed, brief description of job responsibilities)
Your answer
Relevant work experience (agency, length of time employed, brief description of job responsibilities)
Your answer
Anything else you would like us to know about you.
Your answer
Reference #1 (supervisor) Name & email address
*
Your answer
Reference #2 Name & email address
*
Your answer
Reference #3 Name & email address
*
Your answer
Send me a copy of my responses.
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