This is the form to edit or delete your record as a therapist using your own own password.

First, fill in your password and enought information to find your therapist record, then you will be able to edit it. Country might be an easy way to start to find your record.

User Password:
FirstName:
LastName:
Degree:
LicensedPractitioner:	Yes No
City:
State:	Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip:
Country:
Languages:
Insurance:
Population:	Select Infants Children Adolescents Adults Geriatric
TreatmentModalities:	Select Individual Group Couples Family
TreatmentMethods:	Select Behavior Therapy Biofeedback Brief Therapy Cognitive Therapy InVivo or Contextual Psychodynamic
ClinicalSpecialties:	Select Addictions Anxiety Disorders Attention Deficit Hyperactivity Bereavement Bipolar Disorder Body Dysmorhpic Disorder Depression Divorce Eating Disorders Family Problems and Treatment Mood Disorders Multicultural Concerns Obsessive Compulsive Pain Control Panic Personality Disorders Phobias Post Traumatic Stress,PTSD Relationship Problems Sexual Dysfunction Sexual Orientation Concerns Sleep Disorders Social Anxiety Spiritual Issues Stress Management Suicide Trauma Women's Issues