Individual Provider Application for Treatment Directory

If you are not already listed in our Eating Disorder Specialist Directory, please consider joining us. Your valuable services are needed and appreciated by our online community of eating disorder sufferers.

To enroll in our Eating Disorder Specialist Directory, simply complete this online membership application form and submit this form along with your payment of $181.50. This fee will cover a one year listing in our Eating Disorder Specialist Directory. Upon receiving your application and payment, we will promptly review your information and build your listing in our Directory. Once your listing is complete, we will send you the URL for your review and approval.

To renew your existing annual listing for a treatment directory listing, please complete this form and make payment of the $181.50 renewal fee.  We will confirm receipt and make any requested adjustments to your listing.

Individual Provider Listing Application

  • ***Please fax or scan / email a copy of your current license and proof of insurance to us within 24 hours.
  • Price:
  • $0.00
  • This field is for validation purposes and should be left unchanged.