Therapist Registration Form

LGBTQ+ Therapists directory registration

Please note: To keep our community safe, the QueerPsych Membership Team reviews each registration thoroughly. If you do not see your profile posted within 48 hours, please reach out to info@QueerPsych.com

Please fill out the therapist profile below today! Monthly Membership for Pre-licensed therapists is $14.95, and for licensed therapists, it's $19.95. To inquire about group rates, please reach out to info@QueerPsych.com

THERAPIST REGISTRATION FORM

Help us make a difference

First Name

Last Name

Email

Profile photo

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Pronouns

Title

License Number

Sexuality

Where Are You PHYSICALLY Located?

This allows our users to search providers nearby to them, for licensing purposes.

Location

If you are licensed in multiple states list them here.

About me

Specialties

Issues

Accepted Insurance Plans

Appointments Availabiliy

Online

In Person

Online and In person

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