Therapist Intern Onboarding Info Form

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Please complete the form below as completely as possible so we can meet your needs and market you correctly. We will follow up with you for approval before your profile is live.

Name

First Name

Last Name

This is where eTherapyCare corporate communications will go. You will be provided an @etherapycare email address as well.

Phone

(###)

###

####

Preferred Start Date

YYYY

Home Address

For Corporate Info only, only state will be shared publicly.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Supervision Requirements

What type of supervision does your program require?

What are your standing hours of availablility?

You're in control of your schedule. Clients prefer regular recurring session times. We will build your available schedule off of the schedule provided here. Keep in mind sessions run in 50-min blocks.

Schedule Preference

Do you prefer to run sessions back-to-back or you prefer a break in-between?

Run Sessions Back-to-Back (except lunch)

I prefer a 10-min break in-between sessions

Other (include instructions in message box below)

All States You Want to See Clients From?

I have malpractice insurance.

Yes

Marketing Bio & Areas of Interest

Here, outline your education, experience, areas of interest when working with clients... what's unique about working with you?

Credentials

List your credentials as you'd like them to be publicly represented

All States Where Licensed & License Number:

Therapeutic Approach

Ideal Client

What type of client do you enjoy working with?

Clients not interested in working with...

What type of clients are you not interested in working with?

Other

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