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Medical/Behavioral Health contract request
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Medical/Behavioral Health contract request
Location details
Organization Details
Practitioner details
Expertise/Services
Tell us about your areas of expertise or services:
Providers are responsible to accurately represent their areas of competence in a manner consistent with how they have represented their competencies to their licensing bodies.
Please check the specialties that represent the majority of your practice
Populations
(Optional)
Children's Chemical Health Services
Children's Mental Health Services
Men's Chemical Health Services
Men's Mental Health Services
Military/Veterans
Refugees
Women's Chemical Health Services
Women's Mental Health Services
Select Mental Health/Chemical Health Therapy Types you use regularly
(Optional)
ADHD Therapy
Biofeedback Therapy
Chemical Health Assessments/ Mobile
Chemical Health Assessments/ non-Rule 25
Chemical Health Assessments/ Rule 25
Cognitive - Behavioral Therapy
Dialectical Behavior Therapy
EMDR
Faith-based Counseling
Family Therapy
Functional Family Therapy
Hypnosis
Integrative Medicine/ Mind Body
Medication Management + Psychotherapy
Mindfulness Therapy
Narrative Therapy
Neuropsychological Testing
Play Therapy
Psychodynamic Psychotherapy
Psychological Testing
Select Expertise Areas
(Optional)
Mammograms – 3D
Abuse Survivors Group
ADA accessible office
ADA accessible equipment
ADA accessible exam room
Adult Rehab Mental Health Services
After Hours Care
Anger Management Group - Adult
Anger Management Group - Adolescent
Assertive Community Treatment Services
Bone Mineral Density (DEXA)
Chemical Health Detox
Chemical Health Inpatient Treatment Free Standing Facility
Chemical Health Outpatient Treatment - Adolescent
Chemical Health Outpatient Treatment - Adult
Chemical Health Outpatient Treatment w/Lodging
Chemical Health Outpatient Treatment - Senior
Chemical Health Day Treatment
Children's Therapeutic Support Services
Comprehensive Outpatient Rehabilitative Facility (CORF)
CT Scans
Cultural capabilities/specailties
Cultural Competency Training in the past 12 months
DBT Group - Adolescent
DBT Group - Adult
Depression/Anxiety Group
Nationally Accredited Diabetes Education
Diagnostic Radiology
Mammograms - Digital
Distance from Public Transportation: 0 - 5 blocks
Distance from Public Transportation: 6 - 12 blocks
Distance from Public Transportation: over 12 blocks
Domestic Violence Group
Eating Disorders Group
Electronic Health Records
Family Planning/Sexual Health
Free Parking
Group Therapy (Other)
Hearing Screening
Hearing Aid Supplier
Laboratory
Mental Health Day Treatment
Mental Health Inpatient Treatment Free Standing Facility
Mobile Crisis
MRI
Multidisciplinary Pain Programs
Nuclear Cardiology Imaging
Offers Eyewear Discount
Online Appointment Scheduling
Opioid Treatment Program
Optical Shop
PET Scans
Pharmacy
Pool Therapy
Residential Chemical Health
Routine Eye Exams
Sex Offender Group
Sleep Study - Testing Center
Mammograms - Standard
Telehealth
Therapeutic Radiology
Transgender-General Care
Transgender-Hair Removal
Transgender-Surgery
Transgender-Voice Modification
Travel Medicine Services
Urgent Care Department
Vision Therapy
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