Current members of Clinicians Network: to use this blank form for presenting information on your member page, please do the following, and PLEASE DO PROOF THE MATERIAL YOU SEND FOR CONTENT CLARITY AND TECHNICAL CORRECTNESS. I'll try to catch small typos, but copy should be sent as correctly as possible. I'll send a link to your updated page, so it can be approved or changed as needed.

Thanks, 

Jane Thielsen,   Clinicians Network Webtech  

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[Name& credentials, titles etc.][enter data here]

[enter location or mailing address:]

 Office: 541
Fax:  541-
E-Mail: 
Hourly Rate:  
Sliding Scale?:  
Accept Insurance?: 
Medicaid?:  
Handicap Accessible?: 		 Internet: (personal web site address or other important site links for clients)
Practice Description:  [enter data here]
Education: Experience:

[enter data here]

 [enter data here]

Please delete areas/categories of practice you don't want to include:

Area of Practice: Specialization:
Aging and Life Transitions

Anger

Anxiety, Panic & Phobia

Attention Deficit Disorder

Childhood Problems

Death & Dying

Depression

Personal Growth

Sexuality, Sexual Abuse & Sexual Disorders

Spirituality & Religion

Teens

  
Populations Served:
Adults, Elders, Teens, Groups