Employment Questionnaire
Holistic Health Counseling Center Employment Questionnaire
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Your Name *
Your Full Name
Are you fully licensed  in the State of New Jersey as an LPC, LCSW, LMFT, or Psychologist? *
Are you paneled with any insurance? *
If you are paneled with any insurance, which plans are you paneled with?
Are you pre-licensed as an LPC, LSW, LAMFT, or Psychologist? *
If pre-licensed, when do you anticipate being fully licensed?
approximate date
Please tell us about your specialty/niche(s). List any previous experience, or any other information that shows your ability to work with that population(s). *
At this time, we are 100 percent telehealth with plans to be in person with a telehealth option once it is safe to be in person. Are you comfortable with providing telehealth services 30 hours a week until we are safely able to offer an in person therapy option? *
Are you available to work (seeing clients) 30 hours per week? *
We ask that our clinicians work either 2 nights (4-9pm) or 1 night (4-8pm) and 1 weekend (at least 6 hours).. Are you okay with that? *
Who is your ideal client? *
Can you tell us about your past or current client contact hours? For example, I see/saw 35 clients a week OR my job is/was 50 percent group therapy and 50 percent individual counseling, with a total of 25 hours a week client contact hours. *
We would like to understand how you may look at expectations. Please take this short quiz and tell us the result: https://quiz.gretchenrubin.com/four-tendencies-quiz/ *
Please enter your result type
Please tell us what your ideal schedule would look like: *
Your answer
Do you have previous private practice experience? *
Your answer
Holistic Health Counseling Center (HHCCNJ) is seeking seasoned psychotherapists who can commit to working solely at HHCCNJ. We believe that clinicians will be more invested in our culture and mission this way, and we want good work/life balance for our team. Will you be working in your own private practice or at another group practice if employed at HHCCNJ? *
If you answered "yes" please explain.
We are committed to social justice, diversity, inclusiveness, multiculturalism, and are anti-racist. Do you share this commitment? Ideal candidates exhibit a strong commitment to these principles. *
Are you interested in providing community speaking engagements or workshops? For example, at a school or corporate setting? (This is not a requirement of employment) *
If Yes or Maybe, please tell us more about what you would like to do or have done in the past.
Your answer
Our clinicians are able to work independently and follow directions easily. Do you feel comfortable working independently and being able to follow through on keeping your office hours schedule, billing credit cards via the EHR, keeping notes accurately and timely, responding to emails and phone calls in a timely manner, and staying organized? *
Why do you want to work in a group practice? Why HHCCNJ? *
Your answer
What are your long term goals (1-3 years out)? Personally and/or professionally *
Your answer
What can you bring to HHCCNJ that sets you apart from other candidates? *
Your answer
How did you hear about us? *
Your answer
Tell us about your personality. How would colleagues describe you? *
Your answer
Thank you so much for completing this questionnaire. We will contact you soon.
If you haven't already sent us your cover letter and resume, please email them to info@hhccnj.com.
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