Join the Collective

Clinician Membership Application

Tell us about your background, clinical focus, and how you work. This helps us understand whether there's a mutual fit and what kinds of clients we might introduce to you.

HIPAA-Compliant Application Process

All information is encrypted and stored securely in compliance with HIPAA regulations.
Your data is only accessible to authorized CTC administrative staff.
We never share your personal contact information with third parties without consent.

Our Standards

How Our Vetting Process Works

We Evaluate

Licensure, clinical specialization, therapeutic approach, and alignment with our network.

Capped by specialty & region

We Review

Reviewed within 5–7 business days. Membership activates only after acceptance.

Monthly billing begins after approval

You Join

Onboard, build your profile, and access referrals, peer consultation, and community events.

Curated network, not a directory

Some specialties and locations may periodically reach capacity.

1About You

Full Name *

Credentials *

State(s) of Licensure *

License Number *

Please list number and state for each license

License Valid Until

Earliest expiration date if multiple licenses

Years in Practice *

Email Address *

Phone Number

Practice Website *

How did you hear about Curated Therapy Collective? *

2Your Practice

Practice Name

Are you part of a Group Practice? *

City *

State *

ZIP Code *

Session Format *

Select the format(s) you offer

Are you currently accepting new clients? *

Yes

Scheduling & Availability *

Help us understand your scheduling preferences and availability for new client referrals

Average Session Rate

Additional Languages

Select any languages your practice offers beyond English

3How You Work

Areas of Expertise *

Select your areas of expertise.

Modalities or Approaches Used *

Select your therapeutic approaches.

Populations Served *

Professional Journey *

Therapeutic Style *

Unique Strengths *

Schools Attended

Include degree type and institution name

Additional Certifications

Include certifications, specialized trainings, or continuing education

4Your Ideal Client

Do you work with private-pay clients? *

Yes

Do you accept insurance? *

Yes

Ideal Client Fit *

What would make a referral an excellent fit for you?

5Your Profile

Profile Photo

(square photo, subject centered, max 2MB)

JPEG, PNG, or WebP • Max 5MB

Professional Social Media Links

Add your professional profiles (optional)

Instagram

Facebook

YouTube

TikTok

6Membership

CTC Membership

$125/month or $1,375/year

Monthly billing begins after acceptance and onboarding.

✓ Directory listing with full profile

✓ Curated client referrals & priority matching

✓ Peer consultation & community events

✓ Featured placement & dedicated support

Application fee: A one-time $99 application & profile setup fee is collected with your application.

$99 application fee collected at submission. Membership billing begins after acceptance and onboarding.

7Our Agreement

Key Terms Summary

•Monthly Billing: $125/month, billed after acceptance.
•Application Fee: A one-time $99 fee is collected with your application.
•Cancellation: After the 12-month commitment, cancel with 30 days' written notice.

I have read and agree to the Curated Therapy Collective Membership Agreement. *

I understand that CTC membership is billed at $125/month. Billing begins after my application is accepted.

Electronic Signature

By typing your full legal name below, you are providing an electronic signature that has the same legal effect as a handwritten signature.

Type Your Full Legal Name *

Your Privacy Matters

How we protect your information

We take your privacy seriously. Your application data is encrypted, accessible only to our administrative team, and never sold or shared with third parties.

Encrypted

Secure Access

Admin Only

Never Sold

Liability insurance required: Clinicians must maintain their own professional liability (malpractice) insurance. CTC membership is separate from your individual practice obligations, including HIPAA compliance and Business Associate Agreements.

8Your Affirmation

I affirm that I hold an active license in good standing, maintain my own professional liability insurance, and am responsible for HIPAA compliance in my practice. I understand CTC is a professional collective—not a group practice. I agree to uphold CTC's ethical standards and notify CTC of any licensure changes. *

Your information is protected. All application data is kept strictly confidential and used only to review your membership application.

I understand that connections are based on clinical fit and availability; volume may vary.

You'll receive a confirmation email after submitting. Applications are typically reviewed within 5–7 business days.