Εκδήλωση ενδιαφέροντος συνεργασίας

First name

Last name

Gender

Male Female

Date of birth

Phone

City of residence

Bachelor’s degree

Bachelor’s degree institution

Master’s degree

Master’s degree institution

PhD

PhD institution

Seminars

Certifications

Do you hold a license to practice as a psychologist?

YES NO

Have you completed psychotherapy training?

YES NO I am currently in training

Is the organization you trained with certified by the European Association for Psychotherapy?

YES NO

Which psychotherapy training are you certified in?

Which organization certified your psychotherapy training?

Are you in supervision?

YES NO

Have you undergone personal therapy?

YES NO I have completed therapy

Your psychotherapy work setting

I work for or in collaboration with a clinic/center (employee or contracted) I am self employed and run my own private practice (my own office) Other

How many years have you been practicing psychotherapy?

Have you started business activity / can you issue invoices for services?

YES NO

Tax ID

Hours of availability per week

Profile picture

Comments

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