Medical and Counseling Affiliates Application Form
Welcome and thanks for your interest in becoming part of the AskTheInternetTherapist.com Team!
We are in the process of accepting applications for allied health care associates. We are planning on providing not only quality online mental health counseling, but a complete health services clinic. To accomplish this goal we would like to invite counselors, social workers, psychologists, psychiatrists, and general physicians to join.
The fees are very reasonable and include $350.00 to join, $100 a year for continued development and 10% of what is made from clients coming from this site. We will provide credit card payment access and continuing web development. We also include aggressive marketing for the team.
If you are interested in joining please fill out the data sheet below. Afterwards, please mail a copy of the signed contract (either the html or Microsoft Word version), a jpeg picture, a 450-word biography, a copy of your resume, your current credentials, malpractice insurance information, the mediums and times in which you want to be listed on the site, to the address below (you may also e-mail files to firstname.lastname@example.org -this method is preferred). You will be notified by mail of your acceptance when we receive and review your information and at that time the joining fee of $350.00 should be sent to the same address (at this moment we only accept checks through regular mail). At the present time we do not provide an 800 telephone line so if you choose to work in that medium that cost will need to be absorbed by yourself. If you choose to work with the audiovisual medium it is necessary for you to provide a webcam and microphone. All these are very economical, between $20-$150. After you have signed up and been notified of your acceptance you may enter the provider area and set your time availability.
We look forward to working with you. Also if you would like to link our site to yours feel free to copy the banner below and we would be happy to display yours. Thank You.
Jef Gazley, M.S., LMFT