SELF CENTERED BODY & WELLNESS
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VA CCN Provder
Private Pay
SELF CENTERED BODY & WELLNESS
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Employment Application
What position are you applying for?: *
Massage Therapist
Administrative Assistant
Full Name *
Address: *
Phone Number: *
Email Address *
Are you legally eligible to work in the U.S.? *
Yes
No
Have you ever been convicted of a felony? *
Yes
No
If yes, please explain:
Desired Start Date: *
Availability: *
Full -Time
Part -Time
On Call
Preferred Schedule: *
Monday
Tuesday
Wednesday
Thursday
Friday
Education and Training (List the institution, Degree/Certification, Dates Attended): *
Relevant Certifications (e.g., HIPAA, Office Admin, Trauma-Informed Care): *
Please describe your experience with administrative support in healthcare or wellness settings: *
Do you have experience with any of the following (check all that apply:) *
Microsoft Office Suite (Word, Excel, Outlook)
Google Workspace
Scheduling Software (e.g., Acuity, Jane, Simple Practice)
SOAP Notes or EHR Systems
CRM or Client Intake Platforms
Social Media or Marketing Tools
Inbound/Outbound Calling
List your two most recent employers, position, dates worked and reason for leaving: *
Provide two professional references (name, relationship, phone or email: *
Why do you want to work at Self Centered Body & Wellness, and how do you support trauma-informed, client-centered care in an administrative role?: *
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Location
632 W Prospect Avenue
28376 Raeford