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Are You A Mental Health Professional?

Basic Information
First Name *
Last Name *
Contact Number *
Email ID *
State *
City *
Current Practice Type*
Languages you offer therapy in*
Professional Details
Type of Mental Health Professional*
Years of Overall Experience*
Working under Supervision?
Highest Education Details
Degree*
Field of Study*
Institute Name*
Year of Start*
Year of Completion*
Upload Degree / Diploma(1)*
Upload Degree / Diploma(2)
Upload Degree / Diploma(3)
Work Experience
Organization Name
Role/Designation
Type
Start Year
End Year
Specializations
Area of specialisation*
Therapy Approaches*
Client Types*
Additional Training & Certifications
Course / Certification Name
Institute / Organization
Duration
Year Completed
Certificate upload
Practice Details
Mode of Delivery*
Session Fee Range*
Bio (100-150 words)*

Photograph*
Gender *
Date of Birth *
Secondary Contact Number
Website URL
Professional Hours till Date
Your Message
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These Terms and Conditions (“Therapist Terms”) are with reference to your intention to register with The Live Love Laugh Foundation's ("TLLLF") website: thelivelovelaughfoundation.org("Website"), as a mental health professional. The Terms of Use and Privacy Policy of the Website are hereby incorporated in these Therapist Terms by reference.


If you wish to register with the Website as a mental health professional, you grant TLLLF the right and license to publish your name, designation, location, phone number and email address on the Website, at TLLLF’s discretion. Notwithstanding the above, you agree and understand that TLLLF has the right and not the obligation to publish the details concerning you. If you are listed on the Website as a therapist, you agree that 


In the event that it is brought to TLLLF’s notice that you have advertised, marketed, or portrayed yourself or your practice as a TLLLF employee, TLLLF has the right to remove your credentials on the Website, and direct you to remove any posts/content in relation to TLLLF.

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