Form

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First name*

Last name*

How/through whom did you hear about moka.care?

Could you please provide your contact email address?*

Could you please provide the phone number where we can reach you?

I am a psychologist....

I am a state-certified psychologist, from a psychology school, with a university master's degree or a doctorate in psychology. I confirm that I am supervised or part of an intervision group.

I do not meet these criteria

I am a therapist...

I confirm that I am a state-certified therapist, trained in hypnotherapy (ARCHE, Institute of Interpersonal Hypnotherapy), in sophrology (Institut de Formation à la Sophrologie) or in marital counseling (Fédération Nationale Couples & Familles ).

I do not meet these criteria

I am a coach with....

an official certification (Fédération Internationale du Coaching or ICF, association européenne de coaching, formation Linkup Coaching,etc).

I do not meet these criteria

How many years of experience do you have in your practice?

Can you briefly describe your experience?

In which year did you obtain your degree, or when are you expected to obtain it?*

If you have already obtained it, can you share your diploma with us?

Do you have experience in leading group sessions?

Yes

Do you have experience in content creation?

Oui

Non

Practical information

If you are a psychologist, what is your RPPS number or its international equivalent?

Are you part of the MonPsy program?

In which country do you practice?*

If in France, in which departement do you practice?*

In which city or cities do you practice?*

Do you provide your services online and/or in person?*

Online

In person

What is your rate for individual sessions? (€)*

What is the link to your website or LinkedIn profile?

Could you share your resume with us?

Would you like to share any additional information about your profile with us?

Please fill in below your potential availabilities for a collaboration.

If an option does not apply to you, you can leave the field blank.

Please specify the number of hours, days or half-days you could devote to this activity, as well as the corresponding days of the week.

In-person availibilities

Online availabilities

Moka synchronises with our practitioners' Google calendars so that they can manage their appointments independently.
What are your habits with this tool?

Please note that we do not have access to the content of the agenda, but only to the information indicating whether or not a slot is available.

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Expérience

Type of support

Practical information

Organisation