Freedom From Chronic Pain clinician application form

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Please fill in the following form:

Name *

First and last name

Email *

Country, city, timezone *

Which timezones could you see clients in, given your working schedule? See https://www.worldtimebuddy.com/ to work out if you could see clients in USA / Europe / Australia.

Phone number *

I am interested in (check all that apply) *

Client referrals to my own business

Contract work

Casual employment

Other - please specify in your application

Other:

Required

My professional title is (e.g. somatic psychotherapist, psychologist, social worker, etc) *

My qualifications/studies in psychotherapeutic / counselling modalities and mindbody work are (e.g. Radix, Hakomi, ISTDP, psychoanalysis, CBT, ACT, Online MindBody Training With Howard and Hal, etc):

Number of years of experience working as a therapist or approximate number of client hours post qualification

Number of hourly sessions per week I could work for Freedom From Chronic Pain

I would be comfortable seeing some or all clients over Zoom / videoconferencing *

Yes

Maybe

Other:

Please email your expression of interest (I suggest a one page cover letter and brief CV) to hal@freedomfromchronicpain.com OK?

Submit

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