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Purchase Membership

To be included for inclusion on this site, you must provide us with some information about your practice.

You will be able to pay directly with a credit card through our secure payment processor. (You can also send a check or money order.)

Listing prices: (see a description of all listing options)

Standard Individual $75
Premium Individual $175
Standard Treatment Center $175
Premium Treatment Center $275
Media Referral Page $396

Step 1: Fill out profile (*required fields, all other information is optional--please do not use all caps for your descriptions.)

Where do you want your listing to appear?
State/Province:*
City:*
Name* (and degree if available)
Name of practice or clinic:
Describe your service
Services provided* (300 characters max.):
Title (example: Senior Analyst Coach):
Type of organization:*
Age group served:
Modality (example: groups, individuals, classes, etc.)
Professional Asscociations you belong to (200 characters max):
Fee Schedule (example: sliding scale, set fee, etc.):
Insurance accepted:
Office Hours:
Address
Full Address (incl. state, zip, etc.):
Phone/Fax/Etc.
Phone:
Fax:
E-mail for more info, if available:
Website, if available:
Additional comments, like other areas served, etc. (200 characters max):
Contact information.
Contact e-mail* (this information will not be published. We need this information in case we have a question about your listing.)

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