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* 1. Please provide the following information

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* 2. If licensed in Virginia as an LPC, LCSW, LMFT, or clinical psychologist

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* 3. If licensed in another state as an LPC (or equivalent), LCSW, LMFT, or clinical psychologist

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* 4. If registered as a resident under supervision with the Virginia Board of Counseling or Social Work to complete your supervised post-graduate experience towards licensure, please provide the following information:

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* 5. Are you trained, experienced, and/or excited to work with the following age groups?

  Trained Experienced Enjoy working with 
2-6
6-11
11-18
19-26
Adults
Geriatric

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* 6. Diagnoses Experience & Interests

  Trained Experienced Looking forward to working with Plan to take additional training
Anxiety
Depression
Bipolar
Serious Mental Illness
Trauma/PTSD
Childhood trauma
Developmental Disorders
Addictions (Alcohol/ Substance Abuse)
OCD
Eating disorders
Self harm
Life transitions
Geriatric issues
Health issues
Families
Couples
Military Issues
Parenting
Divorce Discernment
Divorce Support

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* 7. Availability to see clients:

  8am-noon Noon-4pm 4pm-9pm
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays

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* 8. Availability to start

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* 9. What aspects or areas of counseling are you passionate about?

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* 10. What areas of counseling are you interested in gaining additional training?

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