Clinical Internship Application Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Why are you interested in interning with Woodhaven Therapy? * What areas of interest or specialization in counseling do you have? * What counseling theories are you drawn to or do you practice, and why? * Desired Start Date * MM DD YYYY Program Type * Practicum Internship Total hours needed for program * What school to you attend? * Direct client hours desired per week: * Thank you for your application! Our Staff will review and reach out ASAP