FindingStone

Proudly Listed on Find-a-Therapist.com

 

 [ Home ]    [ Find A Therapist ]

View this page in: [ Français | Deutsch | Italiano | Português | Español ]

Registration Form

While Basic Membership is free, we will only include organizations, businesses, or agencies where the name of an individual has been included.  The object of this is to allow clients to choose specific people to work with.  If you want your business, with all of your professionals listed, then consider the Enhanced or Custom membership.  Thank you for abiding by these guidelines.

[FrontPage Save Results Component]

Basic Membership Entry Form

Personal Information

Please fill out the form completely.

Required fields are in red.

Please select one:

Basic Membership Entry Form (Free, limited entry)
Enhanced Membership Entry Form (Link+e-mail listing+services) $10/month (6-month minimum)
Custom Membership Entry Form (Web Page+e-mail listing+services) $30/month (3-month minimum)

Click here for more information and to view samples

NEW
UPDATE (ALL data must be re-entered.)

First Name:

Middle Name:
Last Name:
Credentials:
Other Credentials (not included above):

Minority Affiliation

None
African American    
Hispanic    
Latino
Asian American
Native American
Other    

2nd Language:

Primary Orientation:
(You may enter anything you want
to describe your primary orientation. 
This data will be held in a database but not published.)

Primary Modality:
(You may select multiple modalities by holding down the CTRL key as you click on each selection.  MAC Users: Hold down the "Command" key and click the mouse.)

Adlerian Family Therapy Psychoanalytic
Astrology Feminist Psychopharmacology
Behavioral Freudian Psychodynamic
Bio/Neurofeedback Gestalt Reality
Bowenian Hypnotherapy Regression
Coaching IPSRT SandPlay
Cognitive Jungian Structural/Strategic
Christian Narrative TFT
EMDR NLP Time Line Therapy
Ericksonian Object Relations Transactional
Existential
Please do not confuse your orientations with modality.

Orientation  might mean "drug abuse" or "anxiety."  Modality refers to the way you work on the expressive-supportive continuum.

Office Information

Company Name:
(if other than your own name)

Address:

City:
State/Province:

State/County outside of US/Canada:

Postal Code:

Country:

Telephones

(Please use this format, when possible: "Country Code+(000) 000-0000)"
Voice:
FAX:
Email Address:
Your e-mail will not be listed.  E-mail address is required.
Re-Enter Your E-Mail Address:


Double-check the accuracy of your e-mail address.
License Number:
Web site (if any):  

Please be patient with the Submit button.  If you hit it more than once, you'll leave multiple submissions.
For information and quotes on your personal domain (www.yourbusinessname.com or www.yourname.md) hit the "send information" button and a representative will contact you by e-mail.

 [ Home ]    [ Find A Therapist ]