Families of Kids with Mood and Anxiety Disorders, Inc.

Filling in the gaps for youth mental health

MISSION & GOALS WHOLE FAMILY SUPPORT EDUCATION HOSPITALS/CRISIS UNITS TAKE ACTION/VOLUNTEER/DONATE

Add Care Provider Information
This form is for care providers to add their information, as well as others to make recommendations. If you are making a recommendation, you need not fill out the entire form to submit it.

Category (i.e., Psychiatrist, Therapist, Occupational Therapist, etc.):

Provider name as you would like it listed (including designators such as M.D., Ph.D. or LCSW):

Office name, if any:

Street Address:

City, State, Zip Code:

Phone number (including area code):

Fax number (including area code):

Email address:

Despription of services or specialization:

Would you like to support our organization by giving a presentation to families, writing articles for our newsletter, writing an article for our website, etc.?:

May we subscribe you to our e-newsletter which is sent out monthly?

Please click below to submit your information. We appreciate your time and listing!

DISCLAIMER: Though all attempts are made to provide accuracy, we are not responsible for inacurrate information on the site or that you may find through links that take you off of this site. All information contained within this site is for informational purposes only and not to be construed as medical advice. Please contact your physician for medical advice and treatment.

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