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Filling in the gaps for youth mental health
 
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Add Care Provider Information
This form is for care providers to add their information, as well as others to make recommendations. If you are making a recommendation, you need not fill out the entire form to submit it.

Category (i.e., Psychiatrist, Therapist, Occupational Therapist, etc.):

Provider name as you would like it listed (including designators such as M.D., Ph.D. or LCSW):

Office name, if any:

Street Address:

City, State, Zip Code:

Phone number (including area code):

Fax number (including area code):

Email address:

Despription of services or specialization:

Sometimes care providers offer to support FKMAD. If you would like to support FKMAD in any way, please let us know (i.e., presentations to FKMAD families, writing articles for our newsletter, writing an article for our website, etc.):

We like to designate those providers who actively recommend FKMAD as a resource to their families as an "FKMAD Reciprocal Resource." Actively recommending FKMAD as a resource can be done by posting a flyer in your office, verbally spreading the word about our organization, or by listing us on your website or list of local resources. If you plan to do any of these things, please let us know:

May we add you as a recipient of our FKMAD newsletter which is sent out bimonthly (every two months)?

Please click below to submit your information. We appreciate your time and listing!

 

 
DISCLAIMER: Though all attempts are made to provide accuracy, we are not responsible for inacurrate information on the site or that you may find through links that take you off of this site. All information contained within this site is for informational purposes only and not to be construed as medical advice. Please contact your physician for medical advice and treatment.

©2007-2008 FKMAD



 

Spread the word about our mission!
Print a flyer to share with friends, family, care providers and the community!

FEATURED ITEM!
24: A Day in the Life of Bipolar Children and Their Families
by Janice Papolos 24: A Day in the Life of Bipolar Children and Their Families.