Have you received any Voluntary Separation Incentive Payment (VSIP) from the Federal Government within the last 5 years?
If currently active duty in the U.S. Military, provide anticipated date of separation/retirement or start of terminal leave (mm/dd/yyyy).
If retired from the military provide your rank and the date of retirement:
If retired because of a service connected disability, transferred to the permanent disability retirement list, or currently receiving compensation for a service connected disability, indicate the percentage of the disability:
Date of your last VA letter or other Armed Forces Disability Letter (mm/dd/yyyy):
1. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled, I may be denied an appointment, or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated. I understand that responding "No" to this item will result in my not being considered for this position. As previously explained, your responses in this Assessment Questionnaire are subject to evaluation and verification. Later steps in the selection process are specifically designed to verify your responses. Deliberate attempts to falsify information will be grounds for disqualifying you or for dismissing you from employment following acceptance. Please take this opportunity to review your responses to ensure their accuracy. If you fail to answer this question, you will be disqualified from consideration for this position.
2. Are you the spouse of an active duty military member and eligible for Military Spouse Preference? (You must submit a copy of your military sponsor's Permanent Change in Station (PCS) orders with your application.)
To be eligible you must have been married to your military sponsor prior to reporting to the new duty assignment; AND, must have accompanied your military sponsor on a PCS move; AND, the position for which you are applying must be within the commuting area of your military sponsor's new permanent duty station.
3. Carefully read the following descriptions of education, internship training and license. Select the one that best describes your qualifications for the Clinical Psychologist. Make sure your resume supports your response that you select.
4. Do you possess completion of a one year psychology clinical internship training program that is APA accredited or is judged fully equivalent. If answering "yes", make sure your resume reflects the location, duration (beginning and ending dates including month and year), and specialty of the completed internship. . If your resume does not reflect you possess this internship experience, your resume will not be considered. If your psychology clinical internship training program is not APA accredited it will be your responsibility to demonstrate your training program's equivalence.
5. Do you possess an active, current, unrestricted license as a Psychologist by the recognized licensing agency of a State, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the US Virgin Islands? If answering "yes", make sure your resume lists the type of licensure you possess and from where it was obtained and most recent date it was awarded or submit a copy. If your resume does not reflect you possess, your resume will not be considered.
6. Do you have one or more years of progressively related experience as a Professional Clinical Psychologist? Examples of experience includes experience as a licensed Clinical Psychologist providing screenings, psychological evaluations and clinical treatment of children (birth to 21 years of age) with developmental disorders that negatively impact a child's ability to benefit from their educational program.
For the following task statements, choose the response (A-E) from the list below that best describes your experience and/or training. Select only one letter per statement. Ensure that your application supports all of your responses.
7. Execute clinical psychological diagnostic, strategies, procedures, or intervention services for the Educational and Developmental Intervention Services or comparable program for children birth through 21 years of age with developmental, emotional, or behavior disorders in order to meet the specific needs of the child.
8. Apply appropriate diagnostic or clinical techniques and differentiates among mild, moderate and severe developmental disorders such as: pervasive developmental disorders, family dysfunction, child abuse or neglect, or mental retardation in order to provide treatment to children, birth to 21 years of age.
9. Administer, score, or interpret psycho-diagnostic tests used for diagnosing mental, personality, or behavioral disorders for children and adolescents with complex interpersonal developmental disorder in order to evaluate children, birth to 21 years of age.
10. Evaluate children, birth to 21 years of age for educational intervention in order to determine appropriate level of care.
11. Apply the diagnostic criteria for disorders usually first diagnosed in infancy, childhood, or adolescence as outlined in the Diagnostic and Statistical Manual -IV-TR in order to provide a mental health diagnosis and an appropriate level of care, depending upon the child's level of functioning.
12. Provide consultation to medical, clinical providers or school personnel on pediatric mental health cases in order to educate others.
13. Apply psychological principles, theories, methods and techniques in the delivery of clinical child psychological services in the health care setting of the Educational Developmental and Intervention Services or comparable program.
14. Apply fundamental principles of clinical psychology to the analysis, interpretation, and solutions identified for behaviors exhibited in school or social settings.
15. Evaluate children, birth to 21 years of age with developmental disorders in order to determine treatment.
16. Administer pediatric testing to evaluate and diagnose chronic childhood psychological disorders.
17. Perform interventions in order to identify diagnosis or treat mentally disabled children and adolescent who suffer from disorders.
18. Perform educationally based therapeutic techniques, strategies, or treatment for children and adolescents with developmental or psychological disorders in order to treat patient condition.
19. Provide direct therapy, consultation, or co-teaching models of services to children with identified psychotherapy needs in order to treat children, birth to 21 years of age.
20. Serve as a resource for Educational and Developmental Intervention Services team member on behavioral/psychological issues for children and adolescents in order to convey information.
21. Present psychological evaluation reports to parents, schools, or other medical providers to ensure appropriate medical/educational care is provided to enhance the child's ability to learn.
22. Develop or present instruction to teach parents, educators, family members, volunteers or students in the formulation of treatment plans to assist children and adolescents in meeting their full educational potential.