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.

    Field Visibility Guide

    PublicDisplayed on your public therapist profile
    StaffUsed for matching & admin purposes only

    For questions, contact hello@curatedtherapycollective.com

    Clinician Information

    Please list number and state for each license

    Earliest expiration date if multiple licenses

    Location & Availability

    Group practices have a different fee structure. If selected, you'll be redirected to schedule a call to discuss custom pricing options.

    Select all that apply

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

    Professional Background

    Selection Key:
    Public
    Staff Only

    Choose your top 6 areas. Additional expertise can be mentioned in Professional Journey below.

    Choose your top 6 approaches. Additional modalities can be mentioned in Professional Journey below.

    Practice Overview

    Profile & Social Media

    (square photo, subject centered, max 2MB)

    JPG, PNG or WebP. Crop to fit.

    Add your professional profiles (optional)

    Select Your Membership

    Essential Tier
    $75/month
    or $720/year (save $180)
    Enhanced TierPopular
    $125/month
    or $1,200/year (save $300)
    Monthly
    AnnualSave 20%

    Your selection

    Essential Tier • Monthly Billing

    Amount due today

    $75/month

    i

    Payment Required to Complete Application

    After submitting this application, you will be redirected to our secure payment portal to complete your membership subscription. Please complete the payment process before closing your browser to ensure your membership is activated.

    Membership Agreement

    Curated Therapy Collective Membership Agreement

    1. Membership Overview

    By joining Curated Therapy Collective ("CTC"), you agree to become a member of our professional clinician community. CTC is a paid membership network that connects licensed mental health professionals with clients seeking therapy services through our curated referral process.

    2. Membership Fees & Billing

    • Monthly memberships are billed on a recurring basis and may be cancelled at any time.
    • Annual memberships are billed upfront at a 20% discounted rate.
    • Annual memberships are refundable within the first 30 days only.
    • Membership fees are non-transferable.
    • CTC reserves the right to adjust membership pricing with 30 days advance notice.

    3. Independent Contractor Status

    As a CTC member, you maintain your status as an independent practitioner. CTC is not a group practice and does not employ clinicians. You are solely responsible for your clinical practice, including but not limited to: maintaining licensure, carrying professional liability insurance, setting fees, managing client relationships, and ensuring compliance with all applicable laws and ethical standards.

    4. Referral Process

    • Referrals are made based on clinical fit, availability, and client needs.
    • CTC does not guarantee any specific number of referrals.
    • Referral volume may vary based on client demand and clinician availability.
    • Members agree to respond to referral inquiries within 48 business hours.

    5. Professional Standards

    Members agree to:

    • Maintain an active, unrestricted professional license in good standing.
    • Carry adequate professional liability insurance (minimum $1,000,000 per occurrence).
    • Adhere to the ethical codes of their licensing board (NASW, APA, AAMFT, etc.).
    • Provide accurate and current information in their CTC profile.
    • Notify CTC immediately of any changes to licensure status or disciplinary actions.

    6. Confidentiality & Data Privacy

    CTC is committed to protecting member and client information. Members agree to maintain confidentiality of all client information in accordance with HIPAA and applicable state laws. CTC will not share member contact information with third parties without consent.

    7. Termination

    • Members may cancel their membership at any time through their account dashboard.
    • CTC reserves the right to terminate membership for violation of this agreement, ethical breaches, or conduct detrimental to the community.
    • Upon termination, member profiles will be removed from the directory within 7 business days.

    8. Limitation of Liability

    CTC serves as a referral network and is not responsible for the clinical care provided by members. Members indemnify and hold harmless CTC from any claims arising from their professional practice.

    9. Modifications

    CTC reserves the right to modify this agreement with 30 days written notice to members. Continued membership after the notice period constitutes acceptance of the modified terms.

    I understand that CTC is a paid membership community and that memberships are billed monthly (cancel anytime) or annually at a 20% discounted rate (billed upfront, refundable within first 30 days only).

    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.

    HIPAA Compliance & Privacy Notice

    Protected Health Information (PHI) Commitment

    Curated Therapy Collective is committed to protecting the privacy and security of all information collected through this application. While this application does not collect client Protected Health Information (PHI), we maintain HIPAA-compliant practices for all data handling.

    Data Encryption

    All data transmitted through this form is encrypted using industry-standard TLS/SSL protocols.

    Access Controls

    Application data is accessible only to authorized CTC administrative personnel.

    Data Retention

    Application information is retained only as long as necessary for business purposes.

    No Third-Party Sharing

    Your information is never sold or shared with third parties without explicit consent.

    Important Notice for Licensed Clinicians

    As a licensed mental health professional, you are responsible for maintaining your own HIPAA compliance in your individual practice. CTC membership does not transfer or assume your HIPAA responsibilities. You must maintain your own Business Associate Agreements (BAAs), Notice of Privacy Practices, and other required documentation for your practice.

    For questions about our privacy practices, contact us at hello@curatedtherapycollective.com

    Ethics & Consent

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

    I understand that referrals are based on clinical fit, availability, and client needs; referral volume may vary.

    Applications are typically reviewed within 3-5 business days

    This is how your public profile will appear to clients

    YN

    Your Name

    Verified

    Credentials

    Accepting Clients