Please complete the form below and upload your CV and other evidence in support of your application. "*" indicates required fields Name*Gender*She/herHe/himhe/theyshe/theyPractice Name*Website (if applicable):*Email* Phone Number:Upload C.V*Max. file size: 512 MB. Are you a qualified Counsellor / Psychotherapist, either accredited or otherwise?*Please provide your highest professional qualification, including the qualification title, Awarding Institution, and Year of Completion.Please indicate your fee?*Are you a qualified Relationship and Psychosexual Therapist, either accredited or otherwise?*Please provide your highest professional qualification, including the qualification title, Awarding Institution, and Year of Completion.Please indicate your fee?*Are you a qualified Clinical Supervisor, either accredited or otherwise?*Kindly provide details of your qualification, including the title, awarding institution, year of completion, and any relevant professional registrations. What is your fee?*What attracted you to apply to Talking counselling?*Can you provide therapy in another language?*Describe your personality and how you would support a client in distress.*What do you understand about your responsibilities as a Counsellor/Psychotherapist/Psychologist?*Are you a member of the ICO and what is your GDPR procedures?*Upload documentation Drop files here or Select files Max. file size: 512 MB. Upload documentationDo you agreed to take full responsibility and legal accountability for all client work?* Yes What is your Safeguarding procedures?*Upload proceduresMax. file size: 512 MB. What is your client's contract?*Upload Max. file size: 512 MB. When are you available to see the client?*(Note. 8 am to 9 pm Monday to Friday and Saturday 9 am - 5 pm.) When are you looking to start?*Placement Requirements*Please tick to indicate what you have currently. Membership (BACP/UKCP/Others Enhanced DBS checked Indemnity insurance Clinical Supervisor Qualified in Counselling/Pychotherapy Upload documentsProfessional Memberships / Certificates Max. file size: 512 MB. UploadEnhanced DBSMax. file size: 512 MB. UploadProfessional Indemnity insuranceMax. file size: 512 MB. UploadGDPR CertificatesMax. file size: 512 MB. UploadQualification certificate Max. file size: 512 MB. UploadQualification certificate Max. file size: 512 MB. Data Privacy*This form collects your name, telephone number and email address along with your message so that our team can communicate with you and provide you with assistance. Please check our Privacy Policy to see how we protect and manage your submitted data. I consent to my submitted data being collected and stored Δ
