Provider interest in Akin Mental Health
Thanks for your interest in Akin Mental Health! Tell us about your clinical practice and we'll get back to you about potential partnerships with Akin.
Sign in to Google to save your progress. Learn more
Email *
Your name
*
Your clinic or professional affiliation
*
Where is your clinic or practice located?
How did you hear about Akin? *
Please provide any information about your patient population, your clinical setting, or logistics that may be helpful to start the conversation.
Anything else you’d like to share with us?
Ready to chat with our Clinical Lead, Charlie Davidson?
If you haven't already spoken with someone at Akin, you can use this link to schedule a 15 or 30 min call.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of akinmh.com. Report Abuse