Clinical Therapist

First Name, Last Name, Email, Phone, Resume/CV, Cover Letter

• Preferred First Name optional
• What license do you currently hold? choose any
• What is your current licensure status? (pre licensed or limited permit?) choose one
• How long will you require supervision as you work towards full licensure? choose one
• If you are Pre-Independently Licensed in VA, are you registered with the VA Board as a Supervisee? choose one
• Please list your availability - please specify total clinical hours/week. choose one
• Please list your desired total compensation that you are seeking.   choose one
• Are you comfortable with a hybrid schedule - typically 3 days a week onsite?  choose one
• Are you credentialed with Medicare? choose one
• Have you ever opted out of Medicare (you and your Medicare patients cannot bill Medicare and Medicare patients pay out of pocket)? choose one
• Are you legally authorized to work in the United States? choose one
• Are you a current SOL employee? choose one
• If you were referred to SOL, please list the name of the SOL employee who referred you.  optional
• How did you find out about this opportunity? choose one
• SMS Consent: Do you agree to receive mobile messages from us in relation to this job application? choose one
• Are you currently subject to any agreement or obligation that may limit your ability to perform the duties of the position for which you are applying, including any non-compete, non-solicitation, confidentiality, or other restrictive covenant agreement? choose one
• Will you now or in the future require employer sponsorship to obtain, extend, or maintain authorization to work in the United States? Answer "Yes" if you will require employer sponsorship at any time in the future, even if you are currently authorized to work in the United States (including individuals working under OPT, CPT, TN, or other temporary work authorization) choose one