Private Practice Submission Form Counselor's Choice Award
Submit your free application for Counselor's Choice Award for your private practice!
First Name
Last Name
Email
What was the name of your therapy practice?
What is the website URL of your therapy practice?
What country is your therapy practice?
Is there an age range the you serve?
Is there a clinical special population that you serve or have an area of specialty? If so, what qualifies you to serve that population?
Are there clients with certain diagnosis you do not serve?
What is your "No-Show" policy and cost?
Do you serve students with high suicidality or high risk? If so, what are your safety measures or personal you have?
How frequently do you access supervision or consultation services?
What resources do you have available to your clients when you are out of the office or if they are in crisis?
If you are accepting new clients, what is your current estimate for waitlist time (if any)? Do you offer any resources to clients while on the waitlist?
Please include a 150-300 word description of your practice for customers that can be used Counselor's Choice Award website and blog posts.
Please include a 50-150 word description your background that can be used on Counselor's Choice Award website and blog posts and honoree list.
What is your fee schedule? (What do you charge for intakes, appointments, etc.)
I want to subscribe Counseling Choice Award's mailing list.
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