YOUR RELATIONSHIP TO NCSPP
How did you hear about NCSPP?
Do you plan to renew your membership?
SELECT ONE
Yes
No
If yes, what will motivate you to remain a member? If no, why are you planning to discontinue your membership?
PROGRAMS & SERVICES FOR ASSOCIATE MEMBERS
What would you like to see on a web page for prelicensed clinicians?
We have a listserv for prelicensed clinicians (a way to communicate via email with NCSPP's 100+ associate members of NCSPP). How would this be most useful for you?
(e.g., focusing on one or more of the following: clinical issues; professional development; bulletin board for jobs, office space; networking & referrals; etc.)
We will be planning programs during the next two years. What area of focus would be most useful for you?
(e.g. professional development, networking/referrals, clinical presentations, case conferences, clinical theory, etc. -- please rank your choices if you pick more than one)
Are you interested in finding clinical mentors?
What other suggestions can you make that would help us be the most useful to you as the Prelicensed Clinicians Committee?
ACADEMIC & PROFESSIONAL LIFE
Which best describes you?
SELECT ONE
Current Student in Mental Health Field
Prospective Student in Mental Health Field
Student of a Non-Clinical Discipline
Non-Student with Interest in Psychoanalysis
Other
For students, which school do you attend?
For students, what degree are you pursuing?
SELECT ONE
MFT
LCSW
Psy.D.
Ph.D. (clinical)
Ph.D. (research)
M.D.
Other
For students, how would you best describe your career goals?
SELECT ONE
Private practice
Agency work
Community work
Teaching/research/academia
Combination of the above
CONTACT INFO & FOLLOW-UP
What is your name? (optional)
What is your email address? (optional)
Are you interested in becoming more involved in NCSPP by joining the Prelicensed Clinicians Committee?
May we contact you by email with follow-up questions?
