Dear Fellow Counselors, In order to collect demographic information about the clinical counselors throughout the United States we have created this brief survey which can be completed in less than 5 minutes. All individual responses will be kept confidential.

Sincerely,
Joan Normandy-Dolberg, LPC
Chair, AMHCA Public Relations Committee

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* 1. Gender

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* 2. Age:

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* 3. Number of years in practice

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* 4. Please select the state in which you live, practice and/or attend school:

  Live Attend school Practice
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

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* 5. The area in which I practice is:

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* 6. Please select the highest degree you hold:

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* 7. If you are licensed, which license or licenses do you hold?

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* 8. If you are currently working as a counselor, in which setting or settings are you employed?

Please check all that apply!

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* 9. Do you participate with managed care?

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* 10. If you accept insurance or managed care, do you

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* 11. How long does it take you or your staff person to file an average single claim?

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* 12. What is the average amount of time you or your staff person spends on the phone to get an authorization for a new client?

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* 13. What is the average amount of time it takes to get reimbursement once a claim is filed?

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* 14. With which population or populations do you work? Select all that apply.

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* 15. If you work in private practice, is this your primary occupation?

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* 16. How many hours a week do you work in the field of counseling?

  1-10 11-20 21-30 31-40 More than 40
Hours worked:

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* 17. Approximately how may clients do you see a week?

  0-10 11-20 21-30 31-40 More than 40
Number of clients

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* 18. Earnings: Are you...

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* 19. My approximate annual counseling salary before taxes is

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* 20. Retirement: Approximately how many years do you plan to work before retirement?

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* 21. After retirement do you plan to continue working part time in private practice or elsewhere?

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* 22. Please rate your level of concern about finances after retirement.

  No concern A little concern Moderate concern Serious concern Very serious concern N/A
Degree of concern

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* 23. If you are a student, towards which degree are you working?

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* 24. If you are a student, which school do you attend?

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* 25. Is your school CACREP accredited?

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* 26. To which professional organizations do you belong?

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* 27. How do you usually earn your required CEUs? Please check all that apply.

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* 28. How often do you access the AMHCA website at www.amhca.org?

  Frequency:
Daily
Weekly
Monthly
Occasionally

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* 29. What additional information would you like to see us include in our website?

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* 30. Do you receive the Advocate?

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* 31. For which legislative programs do you wish AMHCA to advocate? (Choose all that apply)

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* 32. Have you attended AMHCA's annual conference?

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* 33. If not, why not?

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* 34. What additional workshops or topics would you like to see us offer?

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* 35. VOLUNTEER OPPORTUNITIES: Are you interested in learning more about helping with the following committees?

  Yes No Maybe
Newsletter
Website
Membership
Workshops
Public relations
Legislative Action
Serving as a Board member from your local area
Starting or working with the state of local chapter
Thank you for taking the time to respond to our survey. We plan to distribute the results to our state chapters and in an article in the Advocate.

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