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FORM CONTENTS
GENERAL INFORMATION
Personal Details
General Questions
Training & Qualifications
Technical & Administrative Skills
Client Interaction & Care Approach
Work Ethic & Team Collaboration
Compliance & Ethical Standards
General Information
Full Name
Email Address
Phone number
Age
Are you legally authorized to work in the United States? (Yes/No)
General Questions
1. Can you tell us about your previous experience working in mental health services?
2. What populations have you primarily worked with (e.g., adults, children, individuals with disabilities)?
3. Do you have 4,000 hours of work experience providing mental health services?
Training & Qualifications
4. Do you have your 245I trainings completed within the last two years?
6. What other relevant certifications or licenses do you currently hold?
7. Have you completed training in crisis intervention or de-escalation techniques?
Technical & Administrative Skills
8. Do you have knowledge or experience using Procentive as a charting platform?
9. Are you familiar with electronic health records (EHR) and documentation requirements for mental health services?
10. How do you ensure accurate and timely documentation of client sessions and progress notes?
Client Interaction & Care Approach
11. How do you assess and develop individualized treatment plans for clients?
12. Can you describe a challenging client situation and how you handled it?
13. How do you incorporate cultural competency into your practice?
Work Ethic & Team Collaboration
14. How do you manage a high caseload while maintaining quality client care?
15. How do you collaborate with other mental health professionals, such as case managers, therapists, and psychiatrists?
16. Are you comfortable providing in-home services or community-based mental health support?
Compliance & Ethical Standards
17. How do you ensure compliance with HIPAA and confidentiality regulations?
18. What steps do you take to stay updated on mental health laws and best practices?
19. How do you handle ethical dilemmas in your practice?
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