Therapy in Barcelona Collaborator Questionnaire
Hello! Thanks for taking the time out to register your interest in becoming a collaborating therapist at Therapy in Barcelona. To streamline the process, please fill out this questionnaire which will take about 10-15 minutes of your time.
Remember to press SUBMIT at the end so you don't lose your work.

Thank you!

Email address *
Your Full Name *
Your answer
Contact details - phone number and email *
Your answer
Address *
Your answer
Emergency contact - name, phone number and relationship (on file in case of emergency at office) *
Your answer
Your N.I.E. / D.N.I - Residency permission # *
Your answer
Please state your qualifications *
Your answer
Languages you prefer to conduct therapy in: *
Your answer
Help us know which clients to refer to you. Please tell us about your specialty or specialties (eg trauma, depression, etc). List any certifications, previous experience, or any other information that informs us about your ability to work with population(s). *
Your answer
Type of therapies *
Your answer
Do you work with (check as many as apply): *
Required
Are there any issues or types of clients you will NOT see (eg PD, eating disorders) or are absolutely out of your field of expertise and experience? Please list them so we can be sure to be aware of your preferences when booking clients
Your answer
Do you have current Malpractice and Public Liability Insurance? *
Are you registered as autonomo (freelance contractor)? *
Have you worked with expat/immigrant populations before? *
Please tell us about your work with these populations. *
Your answer
Are you an expat? How long do you intend to stay in Barcelona? *
Your answer
Are you available to work (seeing clients) at least 10 hours per week? * *
How many hours per week would you prefer to work? Please state how many hours if more, and if less than 10 hours. *
Your answer
Are you available to work nights or days or both? Please give us your ideal schedule and indicate times (eg Mondays 0900-1500; Wednesdays 1400-2000). Please be very clear and specific about your availability so we have this information to enable booking of clients. *
Your answer
Will you be running groups? What type of groups?
Your answer
When clients contact us we want to be able to schedule a session for them in the moment, rather than have them write multiple emails to various therapists. Are you willing to add your diary to our practice management system HealthKit so that we can see your availability and easily book clients in with you when you are at our therapy space? *
How do you want clients to contact you after we book their appointment and if they need to contact you outside of sessions? We will provide this information to clients once we book them in with you. *
Required
What's your availability for clients outside of sessions? *
Required
What's your cancellation policy and how do you implement it? We will provide this info to clients when they book with you. *
Your answer
Do your offer reduced fee places? If so, how many and what is your lowest fee (eg 40 Euro, 50 Euro)? *
Your answer
How long are individual sessions? Do you have longer sessions and when? *
Your answer
How long are couple/family/kid/other sessions, please state? *
Your answer
How much do you charge for individual sessions? *
Your answer
How much do you charge for family sessions?
Your answer
Are there any other fee differences I need to know to notify clients of when they ask to book? Please mention them here.
Your answer
How much do you charge for couple sessions? *
Your answer
What's a short description of you and your service that we can put in an email to clients when we book them in with you? *
Your answer
Please finish this sentence to convey what you would like clients to know about therapy..... "Therapy is.......................................................... *
Your answer
Do you have previous private practice experience? *
If yes, please tell us about your previous private practice experience. *
Your answer
Our practice is very collaborative. We may focus on helping the community by way of marketing, networking and providing community speaking engagements. Are you comfortable with this? *
Our collaborating therapists are not employees, they are autonomos (freelancers), who work independently. Do you feel comfortable working independently and being able to follow through on scheduling your existing clients, taking payments, keeping notes accurate and timely, responding to emails in a timely fashion, and staying organised?
Do you agree to keep comprehensive notes and complete notes by Friday of each week to ensure that you are maintaining consistency in your practice and also meeting malpractice insurance requirements? *
Why do you want to run your practice in a group center? Why Therapy in Barcelona? * *
Your answer
What are your long term goals (1-3 years out)? Personally and/or professionally. * *
Your answer
What can you bring to Therapy in Barcelona that sets you apart from others who wish to work as a collaborator in the group setting? * *
Your answer
Tell us about your personality. How would colleagues describe you? * *
Your answer
Have you sent a jpg photo of yourself to put on the team section of the website or on marketing material to Leigh at info@therapyinbarcelona.com ? *
Have you sent a copy of your qualifications to Leigh at info@therapyinbarcelona.com ? *
Do you consent to Leigh Matthews sending a copy of your qualifications and any other information required to Balens Insurance - the insurer that covers Therapy in Barcelona? *
Do you have current malpractice and liability insurance? (If not, please talk to Leigh about this asap!!) *
Have you sent a copy of your current malpractice insurance and liability insurance to Leigh at info@therapyinbarcelona.com ? *
Have you sent a copy of your current registration/licenses to practise to Leigh? *
Have you sent a copy of your consent form/other forms you use with clients to Leigh at info@therapyinbarcelona.com ? *
Do you commit to being collaborative with your peers at the center and helping them, by, for instance, sharing networks and information, offering support, informal peer supervision, sharing a joke, reminding each other about self-care, keeping the center and spaces tidy as you found them, or opening the front door for clients when colleagues are in session and you are not? *
Do you agree that you will NOT diagnose or provide services to people with severe mental health issues, at grave risk of harming self or others? Do you agree to refer these clients to appropriate clinical services (eg E.D., psychiatrist, local clinical service, etc)? Please reach out for support around cases if you are ever in doubt and we will work it out together. *
Do you consent to signing a direct debit form to ensure we can organise payment of for services provided to you on a monthly basis? *
If no, how would you prefer to pay for services provided to you by Therapy in Barcelona? *
Your answer
Do you need help with finding any of the following?
Would you like to book a paid consultation with Leigh for assistance with establishing any of the above?
Thank you for taking the time to respond. We will reach out shortly to make an appointment with you to complete paperwork and to go through HealthKit training and policies and procedures for the therapy space.
If you haven't already, please email your C.V. to Leigh Matthews, info@therapyinbarcelona.com

This form collects information so that we can provide services to you. Check out our privacy policy for the full story on how we protect and manage your submitted data https://www.therapyinbarcelona.com/privacy-policy/

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