All Ages All Abilities

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your highest level of education?

What is the best job you have ever had? Why?

What is the worst job you have ever had? Why?

How many years of experience do you have?

What motivates you in your profession?

What are your career goals?

Why do you want to join the Fix It PT Team?

What skills do you have to offer the Fix It PT mission?

How do you find the most success in building a consistent schedule of patients?

How many hours are you looking to work in a week?

If you are a physical therapist, are you interested in learning our manual therapy techniques?

Very Interested

Maybe

Not Interested at All

Tell me about the last time you made a mistake.

Have you ever felt your skills were not good enough for the task? Explain.

What are you work/life balance expectations?

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