Accessible Membership Application | Bridges Clinician Community

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This application is for free access to the Bridges Clinician Community listserv. At this time, those who are approved will be given free access to the listserv for 1 year. If you're approved, you'll receive an email that you've been added to the listserv.

Visit bridgesmentalhealth.com or email us at bridgesmentalhealthnyc@gmail.com with any questions.

Full Name: *

Email: *

Please enter the email you'd like to use for the group

Occupation: *

Address: *

Total household income: *

Number of people in your household *

# of people supported by household income

Please provide a brief explanation of need: *

How did you hear about the Bridges Clinician Community? *

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