Student Member

Students who are not Licensed Mental Health Professionals (LMHP/LIMHP) or Provisionally Licensed Mental Health Professionals (PLMHP).

Price:

$25 for 1 Year

First Name:* First Name Required

Last Name:* Last Name Required

Office Phone: Office Phone is not valid

Cell Phone:* Cell Phone is Required

Office Location (City): Office Location (City) is not valid

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Email Address (To Be Included in Find a Clinician): Email Address (To Be Included in Find a Clinician) is not valid

Website (To Be Included in Find A Clinician): Website (To Be Included in Find A Clinician) is not valid

Education Level:* Education Level is Required

AssociatesBachelorsMastersPh.D.Other

AAMFT Member:* AAMFT Member is Required

YesNo

AAMFT Approved Supervisor:* AAMFT Approved Supervisor is Required

Not a SupervisorAAMFT SupervisorAAMFT Supervisor Candidate

Field:* Field is Required

Marriage and Family TherapistClinical Social WorkerPsychologistProfessional CounselorOther

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

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