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Basic Information

Full Name*

Date of Birth*

Gender*

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Pronouns

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Email ID*

Phone Number*

Current Location*

Education & Experience

Bachelor's degree*

Bachelor's degree - year of completion*

Master's degree*

Master's degree - year of completion*

Additional diplomas/certifications/licenses

Date of starting clinical practice*

Approximately how many hours of 1:1 therapy have you conducted to date?*

Clinical Practice

What therapy modalities/approaches are you trained in and actively practice?*

What are your primary areas of clinical experience? (Select up to 5)*

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Which client populations do you have substantial experience working with?*

Adolescents

Young adults

Adults

Couples

Families

Older adults

Other

What do you feel are your strongest areas of practice? Are there any areas where you would like more experience, training, or supervision?*

Languages & Mode

What languages are you comfortable conducting a full therapy session in?*

Mode of counselling*

OnlineOfflineBoth

Availability

How many therapy hours can you realistically commit to TLHC each week?*

0-1010-2020-3030-40

Note: This is a consultant position, ideally requiring 10-15 hours of availability every week.

Which days are you available?*

WeekdaysWeekendBoth

Are you currently working, interning, or volunteering elsewhere?*

Why do you want to work with TLHC?*

Kindly accept theterms & conditions.

In crisis or thinking about harming yourself? Call Tele-MANAS on 14416 (free, 24×7) or 112 in an emergency. The Love Hope Company does not provide emergency services.

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Contact Info

support@thelovehopecompany.com

2nd Floor, 25, Thirumalai Pillai Road, Thirumurthy Nagar, T. Nagar, Chennai, Tamil Nadu 600017

Office Hour: 11:00 AM - 08:00 PM

Sunday Holiday! (Online Sessions Available)

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