Join our network

We are seeking licensed or certified behavioral healthcare practitioners to join our provider network. If you are interested in providing coaching or counseling services using our award winning web application and, or would like additional information on our ICF-accredited coach training program please fill out the form below. One of our Provider Network team members will contact you shortly.

Network Sign-up Application

All fields are required in order to submit an application.

First Name

Last Name

Address

City

State

Zip

Email (primary)

Phone (primary)

List Graduate Degrees

Select Licensure or Certification

Coach Credential

ACTP Hours

Other Non-ACTP Training Hours

Would you be interested in coach training?

Additional Resources

Join our network

Network Sign-up Application