Our Mission
We Do The Rest
Join Our Team
Our Mission
We Do The Rest
Join Our Team
Contact for Agencies
Name
*
First Name
Last Name
Company Name
*
Website
*
http://
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Phone
*
(###)
###
####
message
State(s) where patients would be seen:
*
Number of hours per week you anticipate you will need (16 hours/week is the minimum; no limit on maximum):
*
Speciality requested (check all that apply):
*
General Adult Psychiatry age 18 and up.
General Adult Psychiatry age 15 and up.
Perinatal
Child and Adolescent
Addiction
Forensic
Geriatric
Consultation Liaison
Emergency
Hours of the day you want coverage (check all that apply):
*
Between 8 AM and 5 PM
Between 5 PM and 8 AM
Monday-Friday only
Weekends
Holidays
Please give a date when you would want services to start at your facility:
*
MM
DD
YYYY
We are looking for:
*
Temporary services only
Permanent, ongoing services
We are looking for (check all that apply):
*
MD/DO
NP
PA
PhD/PsyD
Master's Level Therapist
Social Worker
We are currently using telepsychiatry services:
*
Yes
No
If yes, what company?
We have used telepsychiatry in the past, and our staff is familiar and comfortable with the process:
*
Yes
No
We currently have high speed internet of at least 10 Mbps download speed and 5 Mbps upload speed:
*
Yes
No
Don't Know
Thank you!
