Join Us — Therapist Circle

Read This First

This contact form is only for ASSOCIATE LICENSED PROFESSIONAL THERAPISTS interested in joining Therapist Circle.

Once you have submitted your application it may take up to four weeks to review and arrange an interview.

There are fees for membership. Please take a look at our membership pricing before applying.

Are you a client? Please click the “Pick Your Therapist” button at the top of the page - do not submit this form to ask for an appointment or any other communication - your submission will not be seen by a therapist.

Are you a marketer? Sorry, we do not accept unsolicited marketing, and especially in a form meant for another purpose. Know that when we do come looking for some service that you might be selling, we will purposely exclude anyone on our spammer list from our potential vendors. We understand you will ignore this and try to spam us anyway and of course it will be automatically marked as spam and then automatically deleted unseen - but you just gotta be you, so knock yourself out!

Your Current Professional License Type

Your License #

Your Practice Business Name

Your Name

First Name

Last Name

Your Phone

(###)

###

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Your Email

Your Practice Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Disclaimer: By providing my contact information, I acknowledge and give my explicit consent to be contacted via SMS. Message and data rates may apply. Message frequency may vary. Reply STOP to opt out.