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Listing Update Form

Please fill out the form below if you currently have a profile on ManhattanAlternative.com and would like to make updates to your profile (please fill out only what you’d like updated).

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"*" indicates required fields

Honorific (if you would like it to appear on the site)

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 50 MB.
Please indicate the Provider Type filter(s) you would like to be included in (must have related credentials to be included in the therapist, psychiatrist/medication management, and health care provider categories):
Please indicate the Provider Availability filter(s) you would like to be included in:
Please indicate the client age populations you work with:
The following category filters are to help clients narrow down their search for providers, please indicate the category filter(s) you would like to be included in (in other words, these categories indicate providers' therapeutic specializations, not necessarily providers' identities):
The following category filters are to help clients narrow down their search for providers, please indicate the Issues filter(s) you would like to be included in:
The following category filters allow clients to identify providers who practice particular modalities or types of therapy/assessments:
In which state(s)/territory(ies) are you licensed and able to work with clients?*
Anti-racist agreement*
Non-exploitation agreement*
Consent*
This field is for validation purposes and should be left unchanged.