Childhood Cancer Therapist Directory
Hello! Thank you for your interest in joining the Family ChemoTherapy referral list for therapists/mental health professionals who work with childhood cancer families.

You are such a valued and needed resource for the childhood cancer community!


Also, please join Family ChemoTherapy's Pediatric Oncology Psychosocial Professionals Network for those who work with pediatric oncology patients and their families! Hope to network and support each other! Please do invite interested colleagues!

 Facebook group: https://www.facebook.com/groups/fcpediatricancerpsychosocialprofessionalnetwork
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Email *
Name *
What type of Mental Health Professional License do you hold?  Please do not abbreviate. Ex: Licensed Professional Counselor. *
What State are you Licensed to practice in? If you are out of the country, please list what country you are able to practice in. *
Email *
Clinic/Agency Name *
Clinic Address. (Street, City, State) *
Business Phone number *
What is your Website: *
Therapy services are provided through: *
Required
I provide the following therapy services: *
Required
If you have group sessions, please share details (who, when, where, how frequent, etc) *
Age Population You Work with *
Required
Fees & Insurance
Fees: *
Required
What Insurance do you accept? *
Required
About You
Please give a brief bio which you would like included in your profile. *
Other Information:
What Languages do you Speak *
Required
What is your experience in Hematology/Oncology? List any special training, certifications, etc) *
Would you be interested in accepting clients on a negotiated rate through Family ChemoTherapy for those who need financial assistance to gain access to therapy? *
If you would accept pre-negotiated rates through Family ChemoTherapy Non-profit grant funds, what amount would you be comfortable accepting for a standard 50 minute session? *
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