Add or Edit Provider Listing


Please fill out the form below, and we’ll add or edit your entry shortly.

Note most fields are not required, so fill in as little or as much as you’d like.

If you are the provider, please provide as much detail as possible.

The content you provide will be made into your listing.

If you are a patient filling out on behalf of your provider, please provide the info you can, and we’ll research the remaining information.

Add/Correct Provider

Provider Details


What you want your heading to be
If you already have a listing, and are looking for us to update it rather than add a new one, select "Correct Existing Listing" here.
Fill this out if there is a primary Dr, like for Dr Smith, or Dr Pruett (where there are both practice names and primary doctors).
Select the practice credentials and accreditations. If the practice has other credentials or accreditations, list them in the note below. Note to see all possibilities, you will have to scroll the page that drops down.
Drop down the multi-select, and choose the ROAs supported by the practice. Note to see them all, you will have to scroll the page that drops down.
Enter these as a comma delimited list, e.g. AK, AR, CO, etc.

Services and Protocols


e.g. Medication Management, Therapy, Yoga, etc. (besides ketamine)
e.g. troches every 3 days, or IV's twice a week, etc. after first consultation. Therapy accompanying, etc.
e.g. Bipolar Type 1 requires referral, must be free from THC, must have a designated driver, etc.
what kind of follow-ups, and the check-in intervals, in what format (e-mail, text, call, zoom, etc.)
How does this practice handle booster doses?
Other things you would like contained in the listing that we haven't asked for. Add credentials not listed above here too.

Insurance Information


Associations


Provider Logo


If you want us to display your logo on your listing, upload a small file with it here.

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