To establish a
new-member page (or to substantially change an existing page), please do the
following:
- 1. Below the
dotted line, select the whole form copy and paste it
into an email message.
- 2. Fill in the
information you want to display on a member page
- 3. Send the
completed form and attach any member photo (as a .jpg under 100k) to
web tech:
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Location/address:
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- Phone:
- Fax:
- Email:
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Hourly
Rate:
Sliding Scale:
Accept Insurance:
Medicaid:
Handicap
Accessible: |
Internet:
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Practice
Description:
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Education:
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Experience:
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Areas
of Practice:
(Please use only these categories and delete the ones that don't
apply to your work) |
Specialization:
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- ADD/ADHD
- ADD/ADHD
- Alcohol and Drugs:
- Anger:
- Anxiety/Panic/Phobias:
- Career & Employment:
- Childhood Issues:
- Chronic Health issues/Pain Management:
- Couples and Relationships:
- Death and Dying:
- Depression
- Developmental Problems:
- Eating and Weight Management:
- EMDR:
- Evaluation Services:
- Family/Parenting:
- Grief and Loss:
- Health (physical), Wellness and Stress Management:
- Learning Problems
- Lesbian and Gay Issues:
- Life Coaching:
- Movement Arts
- Organizational Consulting:
- Personal
Growth:
- Trauma and Abuse:
- Self Esteem Issues:
- Sexuality:
- Sexual Abuse
- Sexual Disorders:
- Spirituality and Religion:
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Populations
Served: |
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Children, Teens, Adults, Elders, groups
(Please use
only these and delete those that don't apply to your work) |
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