Theravive Professional Provider Sign-Up Form

Therapist Quick Sign-Up Form (scroll down for current pricing) Choose A Listing Plan The cities listed to the right are full. Contact us to be put on a wait list when a new slot opens up. Problems with this form? Please call us: (604) 626-1329 (in Canada) or (360)-350-8627 (U.S.) Problems with this form? Please call us: (604) 626-1329 (in Canada) or (360)-350-8627 (U.S.) TOTAL City to Be Listed In (any city /town in the US and Canada) Second City Listing, save 20% Second City, Save 20% : First City: Third City, Save 35% : Third City Listing, save 35% *If your city does not currently exist in Theravive, it will be created for you Your First Name Basic Vs. Premium Listing: A Quick Glance Let Your Practice Soar Tell Us About Yourself Configure Your Service Apply A Discount

All counselors on Theravive receive a professional and attractive listing advertising their business and practice.

BASIC LISTING
•A prominent photo.
•Up to 6 customized primary areas of practice.
•Up to 110 different specializations.
•Full Biography of unlimited word length.  Theravive does not limit any of its counselors in what they want to say about themselves in their practice. 
•Free additional listing (optional) in our E-counseling section for those counselors who are willing to help clients anywhere via e-mail, phone, and internet. 
•A free additional listing as a marriage counselor for those who help marriages (this is effectively two seperate listings for the price of one).
•Link to your own private practice website.
•Unlimited updates to your information.


PREMIUM LISTING
In addition to everything the Basic Listing offers, The Premium Plan gives counselors top placements in our city lists

•Get listed at the top of your city, above all the basic listing entries, regardless of 'alphabetical order' (premium members are always listed at the top of each city, above basic listings, in order of sign-up) 
•A larger photo
•Up to 10 customized primary areas of practice
•Colored highlights on your listing indicating premium status.
•Because Premium Counselors are placed at the top of their city list, it is important to sign up early because once you are placed at the top you cannot be bumped down.
•And of course, as in the basic listing, an unlimited word length biography.

I have read and agree to the Terms of Service You are asked to carefully read the Terms of Service before subscribing. After signing up, you will be able to login and configure your profile, write your bio, and submit a photo. Please allow 3 business days to be added to the directory. Click Here to Read Our Terms of Service / Policy Agreement State or Province of your Listing Name of town / city Have a website? Save up to 100% on your first city by linking to us If You Have Coupon Code, Enter it Here Last Name Your Contact Email Address (for clients) Optional: Your professional practice website (linked in your bio page) Phone Number (with area code) for client contact Password for future account access I am signing up for a clinic or group of therapists Street Address of Local Practice (if applicable) City Postal Code State / Province Professional Title (i.e. Registered Clinical Counselor) Being listed in neighboring towns or cities within reach of your practice adds more exposure Add Exposure and Save with Multiple Listings I will put up a link on my site to Theravive and save

Basic - $120.00 / Year Premium - $199.80 / Year

Designations you want to display after your name (i.e. Ph.D, CMA, RCC). Use commas to seperate multiple designations

Need More Cities? Check This Box Name of town / city Click To Learn How Link Discounts Work (opens in a new window, you will not lose your form)