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Freedom From Chronic Pain clinician application form
Please fill in the following form:
Name *
First and last name
Your answer
Email *
Your answer
Address *
Your answer
Phone number *
Your answer
I am interested in (check all that apply) *
My professional title is (e.g. somatic psychotherapist, psychologist, social worker, etc) *
Your answer
My main psychotherapeutic / counselling modalities are (e.g. Radix, Hakomi, ISTDP, psychoanalysis, CBT, ACT, etc):
Your answer
I would be comfortable seeing some or all clients over Skype / videoconferencing *
Please email your expression of interest (I suggest a one page cover letter and brief CV) to OK?
Your answer
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