Listing Update Form - Manhattan Alternative

Comments

This field is for validation purposes and should be left unchanged.

Name (as you would like it to appear on the site)*

Pronouns (if you would like them to appear on the site)

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

Degrees/Licenses/Certifications (must be directly associated with/in support of the profession you are listing)

If your license requires that you practice under supervision (e.g., LMSW), please indicate the name and email address of your supervisor for confirmation (only if this has changed):

Title (this will appear under your name on the main page; e.g., psychotherapist, psychologist, psychiatrist, etc)

Subtitle/Specialization (this will appear under your title on the main page; usually keywords indicating your areas of focus, specific populations, treatment approaches, etc; see other profiles on the main page for examples)—please note that this line has a maximum of about 24 characters including spaces

Phone (must be a direct phone number, not a general practice phone number; if you'd rather not list your phone number on your profile, please include something else for this field in order to fit the template, such as another page on your website, a different website, or a social media handle)

Email (messages must go directly to you, rather than admin staff at a general practice (unless you're the only person at the practice))

Website (must be to your web page, not a general practice page (unless you're the only person at the practice))

Facebook Page (optional)

LinkedIn Profile URL (optional)

Instagram Handle (optional)

If you would like to update your bio, please enter 100 (minimum) to 125 (maximum) words here:

Upload Photo: Must be a minimum of 640×640 dpi, and maximum 64 MB file size. It's fine to submit photos larger than 640×640 (and up to 64 MB); they will be cropped and downsized to fit. Please do not submit photos with original dimensions smaller than 640×640, as they may be blurry/too pixelated.

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 100 MB.

We are switching our listserv over from Google Groups to groups.io. If you would like to receive an invitation to the new listserv, please add the email you would like to use below! This doesn't have to be the same as the email address listed on your profile, but must be an address that only you monitor (i.e. no team members or administrative staff). PLEASE NOTE that the Google Group will be deactivated on February 28th.

Remove listserv email (if you would like to remove your previous listserv email, enter it here):

Questions, comments, clarifications: