Kristi's List Provider Application
By becoming a certified PPHA provider, your listing is seen by families in Central Texas looking for services through our website and a professional affiliation that demonstrates your dedication to helping those suffering from Perinatal Mood and Anxiety Disorders. PPHA is committed to providing quality, vetted practitioners to ensure that our families in Central Texas are getting the very best services for Perinatal Mood Disorders. If you have any questions, please contact us at info@pphatx.org. Thank you for your interest!
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First and Last Name *
Email Address *
Profession
Business Name
Address
Work Phone Number
Cell Phone Number
Website
Relevant Licenses and Certifications
How did you hear about us?
(Please check all that apply)
Why are you interested in becoming a provider on PPHA's Kristi's List? What are your goals for an alliance with PPHA?
What specific trainings related to working with parents with Perinatal Mood and Anxiety Disorders (PMADs) have you completed? 
(Examples of clinical training(s) include: PSI's 2-day, PPHA, Seleni, Karen Klineman, etc.)
What are some signs/symptoms that a person might exhibit if they are experiencing PMADs?
What do you view as the “cause” of PMADs?
What are your concerns, if any, about becoming a provider with PPHA?
I am interested in:
(Please check all that apply)
What are your general treatment recommendations?
What is the difference between postpartum depression and postpartum psychosis, and how does treatment differ?
What are your views about pregnancy/breastfeeding and medication?
What is your procedure for working with a suicidal patient?
What is your training/experience in crisis management?
In an effort to better serve all families, we are waiving provider dues for therapists of color and providers who are able to provide services in more than one language (bilingual). Please indicate if you are bilingual and/or identify as a BIPOC therapist.
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