Clinician Inquiry

Learn. Grow. Thrive. with Dr. Sheeza Mohsin

Apply for workshops regarding counseling with multicultural clients.

Please complete and submit this form to apply. Please know that this does not guarantee a seat in the pilot or the cohort; we would like this program to be a good fit for you. Please provide us with accurate e-mail and phone information so we can reach you if we need clarification.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Is it ok to text you?

Graduate Degree and the Year it was Conferred

Graduate Degree Major

Do you have any Licensure?

What state or country do you practice in?

What is your cultural background?

What languages are spoken at home?

What languages are you skilled to practice in?

What is the reason for interest in the multi-cultural competence class for mental health practitioners?

What areas of interest do you have after working with this population?

Interests may include couples, women, men, parents, premarital, family therapy, among many others.

What is your preferred format of delivery?

Would you like to be informed of case consultations and skill building webinars for working with multicultural clients of South Asian descent?