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Sharing Our Space at Ash & Birch Counseling
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Legal Name:
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Preferred Name:
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Pronouns:
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Email:
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Phone Number:
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What is the name of your business?
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Do you carry your own liability insurance (including general liability)?
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Please upload business licenses documentation and liability insurance.
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Do you consent to us performing a background check on you?
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Feel free to add any comments on the above:
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Professional Background:
Your Availability:
When do you want to start using the office space?
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How many office spaces do you want to lease?
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How long would you like to lease the space?
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What day(s) of the week would you like the space(s)?
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Compatibility:
How do you handle conflicts or disagreements with others?
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What is your approach to maintaining a clean and professional office environment?
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This office is a non-diet and weight-neutral friendly group practice. Is this compatible with you and your practice philosophy or would it present any conflicts for the work you intend to do with clients? (Please provide examples).
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Anything else you'd like to add?
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How did you hear about us?
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