Living Openhearted Therapy & Wellness Pre-Employment Questionnaire
Hello! Thanks for taking the time out to apply for a therapist position at Living Openhearted Therapy and Wellness. To streamline the process and be sure we are an appropriate match, please fill out this questionnaire. Thank you!

***REQUIRED:  Please send your resume and cover letter to in order to be considered for the position.
Sign in to Google to save your progress. Learn more
Email *
Name *
First and last name
Email *
Phone number *
Where are you physically located?  Are you in CA or PR? 
Please indicate your licensure status (select all that apply) *
Are you available to work (seeing clients) at least 15 hours per week? *
How many hours are you hoping to work each week?  (clients hours plus admin hours per week). *
Please discuss your ideal schedule.  *
Who is your ideal client? *
Please tell us about any certifications, previous experience, or any other information that informs us about your ability to work with that population(s).
What would you say is your preferred psychotherapy modality/clinical orientation? ( i.e. CBT, ACT, MI, psychodynamic etc) *
Living Openhearted Therapy and Wellness has a mission to be values-driven group practice and is looking for clinicians who will be invested in our culture, growth, and mission. Do you plan to be working at another job while employed at LOTW?  *
Why do you want to work at a group practice?  Why Living Openhearted Therapy and Wellness? *
Our practice is committed to profession growth and development.  What are your long term goals (1-3 years out)? Personally and/or professionally. *
Tell us about your personality.  How would colleagues describe you?   *
I have submitted my resume and cover letter to *
How did you hear about us?  *
Thank you for taking the time to respond! We will reach out shortly.
If you haven't already, please email Kristin at with your resume and cover letter.  
Clear form
Never submit passwords through Google Forms.
This form was created inside of Living Openhearted Therapy and Wellness. Report Abuse