Therapist Registration Form

**Please note:

All Therapist account registrations are manually approved by a member of our team. We will reach out to you to continue your registration upon review.

If you are approved to be a member you will have free membership until we have therapists listed in all 50 US states. At that point, pre-licensed therapists will begin being charged $14.95 per month and licensed therapists will be charged $19.95. Group rates are available upon request.

No credit card is needed at this time. We will let you know when we reach our goal.

Name(Required)
Password(Required)
Click the pencil button if you wish to edit the crop of your upload.
Appointments Availability(Required)
Where Are You PHYSICALLY Located?(Required)
This allows our users to search providers nearby to them, for licensing purposes.
If you are licensed in multiple states list them here.
If you do not accept insurance, please state that.
This field is for validation purposes and should be left unchanged.