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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
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Your email
Please share your name and pronouns
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Your answer
What day(s) are you available for an interview?
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Name and pronouns
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Your answer
Phone Number
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Where do you live?
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What are your current credentials, if applicable?
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If you are a student, what university program are you affiliated with, and how far along are you?
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Tell us about the types of training and experience you have had.
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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?
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What are your research interests and background? What are your specialties?
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How did you learn about The Gracious Mind? What drew you to our organization?
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What kinds of skills or knowledge are you interested in gaining from TGM?
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What kinds of skills or knowledge do you have to share with others at TGM?
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What are your thoughts on the role of social justice in the mental health realm, specifically related to power, privilege, and oppression dynamics?
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How do you incorporate multiculturalism into your work?
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Prior to your interview day, please email a current CV, cover letter, & up to 3 reference letters to
applications@thegraciousmind.com
.
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