TimelyCare - 1099 - REMOTE - Licensed Clinical Therapist

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Compensation - Standard

Please provide your compensation expectations.✱

Experience - Crisis Intervention

Do you have experience with crisis intervention, de-escalation, or prevention?✱
- Yes
- No

Licensure - State

What state(s) are you licensed in?✱

Primary Working Location / State Working In - Standard

Which state will be your primary working location?✱

Sponsorship - Standard

Do you now, or will you in the future, require sponsorship to legally work in the U.S.?✱
- Yes
- No

Referral Info

If you were referred, please provide the source of your referral below.

Work or Worked for TimelyCare

Do you currently or have you in the past worked for TimelyCare?
- I currently work here
- I worked at TimelyCare in the past

Distraction Environment

Will you be able to have a distraction free work environment when delivering care?

License Probation/Restrictions

Are any of your licenses currently on restriction or probation?
- Yes
- No

Additional information

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.

Gender

Race

Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American (Not Hispanic or Latino)
A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above five races.

Veteran status

Voluntary Demographic Survey for TimelyMD

Our company values diversity, equity, and inclusion. In an effort to learn more about how we can increase diversity in our candidate pool, we invite you to provide demographic information as part of your application. Providing this information is purely optional. It will not be accessible or used in the hiring process, and has no effect on your opportunity for employment. This information will be kept secure and confidential and will be used solely to evaluate our diversity and inclusion efforts.

What is your age range?
- 18-20
- 21-29
- 30-39
- 40-49
- 50-59
- 60 or older
- I prefer not to disclose this information.
I identify my ethnicity as
Select all that apply
- White / Caucasian
- Hispanic, Latino, or Spanish origin
- Black or African American
- Asian
- Native Hawaiian or other Pacific Islander
- Indigenous Peoples, First Nations, Native American, or Alaska Native
- Middle Eastern or North African
- Some other race, ethnicity, or origin
- I prefer not to disclose this information.
What gender do you identify as?
- Woman
- Man
- Genderqueer / Non-binary
- Some other gender
- I prefer not to disclose this information.
Veteran Status.
- I am a veteran.
- I am not a veteran.
- I prefer not to disclose this information

1099 - REMOTE - Licensed Clinical Therapist - New Mexico