Clinician Interest Form
Hello! Thank you for your interest in working with us at The Gracious Mind Counseling and Wellness Center. Please take a few minutes to let us know a bit about you before we meet.
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Email *
Please share your name and pronouns *
What day(s) are you available for an interview? *
Name and pronouns *
Phone Number *
Where do you live? *
What are your current credentials, if applicable?
If you are a student, what university program are you affiliated with, and how far along are you?
Tell us about the types of training and experience you have had. *
What is your clinical style? For example, what theories do you use, how do you typically engage with people, and how do you see yourself professionally? *
What are your research interests and background? What are your specialties? *
How did you learn about The Gracious Mind? What drew you to our organization? *
What kinds of skills or knowledge are you interested in gaining from TGM? *
What kinds of skills or knowledge do you have to share with others at TGM? *
What are your thoughts on the role of social justice in the mental health realm, specifically related to power, privilege, and oppression dynamics? *
How do you incorporate multiculturalism into your work? *
Prior to your interview day, please email a current CV, cover letter, & up to 3 reference letters to *
A copy of your responses will be emailed to the address you provided.
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