New Therapist Application

THERAPIST


MaleFemale















CREDENTIALING

















YesNo



YesNo



YesNo


THERAPIST BIO
















BIO should be a short paragraph (about 8 sentences) written in first person that is catchy and interesting. Include the following so viewers get an idea of you as a person and a therapist:

• Brief personal info.(Ex. Where you grew up or life experiences that shaped you)
• Your therapy style (in layman terms, not clinical)
• What are you enthusiastic about as a therapist
• What do you believe are the benefits of seeking therapy
• Why your work is meaningful
• # of years you have been counseling, if beneficial

Counselor Chat reserves the right to edit your bio or request additional headshot photos
Upload your professional headshot here.


Company Provison

Counselor Chat, LLC considers this application with the following stipulations and according to the following provisions. Participating therapists will be considered 1099 contract employees and are responsible for all tax payments. Company reserves the right to terminate counselor/therapist listing at any time and for any reason which may be but are not limited to the following:
 Too many therapists in your licensing state
 Too many therapists with your specialty
 Too many technical issues or repeated dropped tele therapy sessions
 Too many negative reviews
 Non-compliance with documentation requests
 License revoked
 Lawsuit filed against therapist

Authentication Signature

The signature below confirms that all the information herein provided is current and true and accurate and signifies agreement with all of Counselor Chat, LLC enumerated policies.