Neuropsychologist - Contract (1099) - Washington

Tacoma, Washington
Provider Network Development – Neurodiversity Center of Excellence /
Contract /
Hybrid

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Neuropsychologist (1099): Relationship with Lyra

  • Psychology Today Profile Link (if applicable)
  • Are you a part of a group practice?✱
  • If selected yes. Please provide practice name, group contact phone, and group contact email.
  • How did you hear about Lyra?✱
  • Are you an employee or contractor of Lyra or an affiliated company (currently or previously)?✱
  • If yes to the previous questions, please select your relationship:✱
  • If you selected other, please share your relationship here:

Neuropsychologist (1099): Credentials

  • Are you a licensed psychologist (PhD/PsyD)?✱
  • Are you board certified?✱
  • if yes, What kind of board certification do you hold?
  • if Other: please provide details of your board certification.
  • Are you a prescriber✱
  • Do you provide psychological assessments?✱
  • Do you require supervision under your current license?✱
  • Have there been any pending or final actions by any state medical or professional board that resulted or could result in any involuntary restriction, suspension, revocation or termination of your currency license or any previous license, other than non-harmful suspensions such as failure to pay dues or failure to complete continuing education?✱
  • Have there been any circumstances relating to any withdrawals by you of any application for, or voluntary relinquishments of, medical staff privileges at any hospital or other health care facility or failure to successfully complete internship, residency or fellowship (if applicable)✱
  • Does your current professional liability coverage meet the industry standards of $1,000,000 per claim and $3,000,000 aggregate OR are you willing to increase your professional liability to $1,000,000 per claim and $3,000,000 aggregate?✱

Neuropsychologist (1099): Clinical Services

  • Do you offer in-person care?✱
  • Do you offer care virtually?✱
  • Do you offer services in any additional languages besides English?✱
  • If yes: What language(s) do you speak?
  • Where is your practice location? (City, State, Zipcode)✱
  • Do you hold a full, unrestricted license in any additional states?✱
  • If yes: Which additional states do you hold licensure in?
  • Are you licensed to practice under PsyPact?✱
  • What is the youngest age client you work with in your practice?✱

Neuropsychologist (1099): Assessment Experience

  • Did you complete an APA/CPA-accredited doctoral program?✱
  • If yes, please provide the university and program name.
  • Did your internship include a neuropsychology rotation or specialization?✱
  • If yes, please describe
  • Please describe any postdoctoral fellowship in clinical neuropsychology and the approximate percentage of your time dedicated to direct neuropsychological assessment, direct assessments for Autism Spectrum Disorder, and direct assessments for ADHD.✱
  • How many years of experience do you have performing comprehensive neuropsychological evaluations independently?✱
  • What are the primary diagnostic populations you have experience evaluating? Check all that apply:✱
  • if Other, please specify
  • What tools do you use (virtual and in-person?) Check all that apply:
  • Are there any other neuropsychological tests you administer not listed above?
  • Which ASD testing certifications do you hold? Check all that apply:✱
  • On average, what is your total time spent on testing?✱
  • Total testing time for Child (ASD and ADHD)✱
  • Total testing time for Adult (ASD and ADHD)✱
  • Describe any experience and expertise treating ASD,(e.g., certifications, training, etc). Please indicate age ranges:✱
  • Describe any experience and expertise treating ADHD, e.g., certifications, training, etc.. Please indicate age ranges:✱
  • Are you able to provide de-identified sample neuropsychological reports upon request?✱
  • Are you open to using a neuropsychological report template provided by Lyra to be personalized by your own use?✱
  • Are you open to peer review of your reports and participation in quality assurance initiatives with our network?✱
  • What is your typical turnaround time for a comprehensive neuropsychological report from the completion to the end?✱
  • What is your current capacity for new referrals per week/month?✱
  • What is your wait time for neuropsychological assessments?✱

U.S. Equal Employment Opportunity information   (Completion is voluntary and will not subject you to adverse treatment)

Our company values diversity. To ensure that we comply with reporting requirements and to learn more about how we can increase diversity in our candidate pool, we invite you to voluntarily provide demographic information in a confidential survey at the end of this application. Providing this information is optional. It will not be accessible or used in the hiring process, and has no effect on your opportunity for employment.

Lyra Application Questions

We invite you to complete this optional survey to help us evaluate our diversity and inclusion efforts. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment or affect your job application. Information obtained will be kept separate from your name or job application. This information will be kept secure and confidential and will be used solely to evaluate our diversity and inclusion efforts.

  • To which gender identity do you most identify?
  • To which sexual orientation do you most identify?
  • Do you identify as a person living with a disability?
  • Are you fluent in any of the following languages?
  • Do you identify as LGBTQIA+?

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