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Creating Change
A Woman's Path to Recovery
Evidence | Compassion | Action
add yourself to our
list of seeking safety providers
Yes! If you fill out the form below, we will add you to this website's list of
Seeking Safety providers.
seeking safety
provider form
*
Indicates required field
Name (this will be listed on the website unless you state otherwise)
*
First
Last
Email (this will be listed on the website unless you state otherwise)
*
Details of your Seeking Safety practice (and be sure to list location, such as city/state)
*
Please be sure to include any info you would like people to see, including: 1. Location of services (such as address, city, state) 2. How you would like people to reach you, such as your phone number and/or email 3. Private practice? Or name of your agency? 4. Your degree and credentials 5. Group or individual Seeking Safety or both 6. Financials (e.g., sliding scale? insurance accepted?) 7. And anything else you believe is relevant. We want to help you obtain referrals. See examples on the site.
Submit
