Application Submission

First Name*

Email

Last Name*

Position applying for

Phone number*

How did you hear about this opportunity at our practice?

Are you acquainted with anyone employed at OIC?

What is your target billable hours per week

What is your timeline for transitioning to a new position?

Primary Populations you wish to serve with any applicable specialized training (check all that apply).

Ages 6-12

Teens

Adults

Couples

Families

Emergency Services Personnel

Other, please specify

Please indicate all payers both public and private for which you are currently credentialed.

Aetna

CareFirst

Cigna

Human Tricare

Johns Hopkins EAP or USFHP

Medicaid (Maryland)

Medicare (MD)

United Healthcare

Other, please specify

Please list any additional credentials or certifications that build on your foundational license (e.g., biofeedback, EMDR, ADHD testing).

Cover letter

Resume*

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Emergency Contact

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1-800-639-8783

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