First Name
Last Name
Email
*
Phone
*
Ok to text on this number?:
*
Yes
No
Town where you currently reside:
Seeking Part-Time Employment (8 sessions per week minimum)?
Yes
No
Seeking Full-Time Employment (20 sessions per week minimum)?
Yes
No
Can you work evening and/or weekend hours, at least in the beginning to build your caseload?
Yes
No
License Type (in state of MA)?
LMHC
LICSW
LCSW
Pre-LMHC
Pre-LICSW.
Other
Other License Type (in state of MA)
Do you require supervision for licensure (provided in-house)?
Yes
No
How long do you see yourself staying in a group practice (minimum of 2 years preferred)?
Where would you like to perform your client sessions?
100% TeleHealth
100% In-Person
Hybrid Model
Number of years working in the mental health field?
Anything you would like to share with the Clinical Director before your first interview?
Please upload your resume here:
I Consent to Receive SMS Notifications, Alerts & Occasional Communication from Leek Therapy.
SUBMIT