List Your Practice

Therapist Profile Application

We would love to include your therapy practice in our directory. We are pleased to offer this service for free! Please fill out the following form and we will review it and respond via email within 2-3 business days.

Name*
FirstLast
Display Name*
How do you want your name displayed on the site?
Profile Image
Please submit an image to display with your profile. This can either be your picture or a logo for your practice.
Email Address*
We respect your privacy. Your email address will not be publicly displayed on the site and will not be shared with 3rd party vendors. We will use your email address to contact you for occasional site update notifications.
Office Phone*
Office Address*
Street AddressCityStateZip Code
Website
Degree*
School*
Year Graduated*
License Number and State*
Therapy Statement*
Tell a little about yourself and your practice. Please do not include html tags here.
Username*
Create a username for your free TherapySprings.org account.
Password*
Enter PasswordConfirm Password
Create a password for your new account.
By clicking on the submit button, you are agreeing with our Terms & Conditions and our Privacy Policy.

Please contact us with any questions that you may have.
Thank you.