Choice Therapy Collective Registration

Please fill out the form below. The form takes 10-15 minutes to complete and partially completed forms cannot be saved.

 

You will need the following to complete the application:

  • 150-300 word bio for your CTC profile page (bio's over 300 words will be edited)

  • Tagline

  • Headshot (if your practice has more than one provider a logo can be used in place of a headshot; however, we recommend using a headshot)

We will review your registration information within 2 business days and we will email you when your account is activated.

The information provided below is used to create your professional CTC web page. You have the ability to update your information at any time. We securely store all applications, uploaded documents, and additional information. Choice Therapy Collective will never share or sell your information.

Your prorated first month's dues will be due upon submission. For quicker processing of your membership, please use the same email address in your registration and payment forms.

Please review our terms and conditions here.

Thank you for becoming a member of Choice Therapy Collective!

General Information
Region:
arrow&v
Which CTC solutions are you most interested in?

Information for Your Profile

The information provided below will be included on your CTC web page. Some of the questions are repeated in different formats. This is for searching and filtering purposes, so please answer all questions that apply to you. 

 

Please only provide that which you would like shared on your personal profile. This information can be updated at any time.

Where do you provide/offer services (check all that apply)?:
arrow&v
SLPs: Please select all areas you are able and willing to treat. This will be listed on your CTC web page, so please do not select areas you are not skilled in or do not want to treat.
Age groups you treat:
Languages spoken:
Payment/Insurance Information:

Provider Bio

This information will be included on your own personalized webpage. We recommend writing your bio in 1st person. This is your opportunity to explain the types of disorders and populations you serve and what makes you unique. 

 

Bios should not exceed 300 words (bios over 300 words will be shortened).

Here are some prompts to help you write a great bio:

  • What is your (brief) professional history?

  • What population does your practice serve?

  • What are your areas of specialty?

  • Who are you and how does it relate to your clients?

  • What is your therapy delivery style?

  • How do you solve problems for your clients?

  • How do you engage clients?

  • How do you involve family and caretakers?

Tagline - practice tagline -or- 2-3 sentences summarizing your business. This is displayed in the main directory.

 

Please do not use quotes. 

Recommended size: 4" x 4"  or 1200 px by 1200 px with up to 300 pixels/inch resolution. Please make sure images are square. If you cannot adjust your image, upload your original file and email us so we can help!

Square proportions
Upload supported file (Max 600 KB)
Are you currently accepting new clients?
Click Submit below to complete your registration and be directed to the payment portal where you will also create your CTC log-in for our member portal.
 
Please use the same email as you listed above to help streamline your registration.
Choice Therapy Collective

Providing speech therapy in Columbus, OH

and speech therapy Kansas City.

  • Instagram
  • Facebook

© 2019 by CUED CREATIVE

7331 W 80th St Unit D Overland Park KS 66024