Employment Interest Questionnaire - Colorado Counseling Center

Thank you for your interest in future employment as a therapist at Colorado Counseling Center. To help us determine if you are an appropriate match, please fill out this questionnaire. At the end of this form you will be able to upload copies of your cover letter and resume (required). If needed, you may save this form and complete it later by using a button at the bottom of the form. If you meet our selection criteria, we will contact you regarding your application and current employment opportunities.

"*" indicates required fields

Name*

Date*

Email*

Current City & State of Residence*

Education, Licensure, & Training

Education*

Do you possess a Master’s or Doctoral Degree in Marriage & Family Therapy, Counseling, Psychology, or Social Work from an accredited University?

Yes

I am currently enrolled in a graduate program.

Anticipated Graduation Date (Applicable Master's or Doctoral Degree)*

Do you possess a Colorado license in a mental health field, including registration with the Colorado Department of Regulatory Agencies?*

Yes

I am provisionally licensed in Colorado (e.g., MFTC, LPCC, LSW, etc.)

I am a Registered Psychotherapist in Colorado.

I am Licensed in another state.

If you are not yet registered, licensed, or provisionally licensed to practice therapy, please continue your education and preparation before submitting.

EFT Training*

As couples counseling is one of the core services offered by Colorado Counseling Center, all of our therapists have training in Emotionally Focused Therapy. Have you completed an ICEEFT approved EFT Externship?

Yes

I'm currently registered for an EFT Externship and can provide proof of registration and payment.

Do you have any additional training in EFT?*

Select all that apply.

I haven't yet completed additional EFT training

I'm enrolled in / have completed EFT Core Skills

I've received supervision from a Certified EFT Supervisor

I'm a Certified EFT Therapist

Other Specialties

In addition to providing EFT for couples, Colorado Counseling Center offers other attachment-informed counseling to individuals and families. Do you have any specific training or expertise in the following specialties? (select all that apply)

EMDR Trained or Certified

AEDP Training

Grief Therapy

Sex Therapy

Therapy with Teens & their Families

Other

Details about your specialties & interests*

Please tell us briefly about your specialties. List any certifications, previous experience, or any other information that informs us about your ability to work with a specific issue or population.

Availability & Schedule

Would you be available to consistently work 4-5 days per week, including at least 3 evenings from 5pm–8pm?*

Yes

Would you be available to work toward sustaining a full schedule of seeing clients for at least 20–25 hours per week?*

Yes

Please share your ideal work schedule.*

Practice Experience & Goals

Do you have previous/current experience in private practice or a group practice setting?*

Yes

Please tell us about your previous/current experience in private practice or a group practice setting.*

Please share your long-term goals as a therapist. If you were in an ideal work situation 5–10 years from now, what would that look like?*

Why do you want to work in a group practice? Why Colorado Counseling Center?*

Characteristics & Values

Tell us about your personality. How would colleagues and clients describe you?

Do you feel comfortable and competent working independently and following through on existing clients, keeping accurate and timely notes, responding to correspondence in a timely fashion, and staying organized?

Yes

I have room for growth in some of these areas

Please share how you need to grow in the above areas.*

How would you want to contribute to building Colorado Counseling Center and being a supportive team member?*

While therapists at Colorado Counseling Center are primarily focused on providing excellent clinical care to our clients, we also are looking for team members who want to contribute to the growth and success of the team and the business. (Select as many of the items below as apply, but ONLY activities you would truly be interested/invested in.)

What would you bring to Colorado Counseling Center that would set you apart from other candidates?*

IMPORTANT NOTE! After submitting this form, you will receive an on-screen confirmation, along with instructions for emailing us a copy of your cover letter and resume.

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