The Institute for Marital
and Sexual Therapy

P.O. Box 12069
San Diego, CA. 92110-3069
Fax: (619)564-8783

Application Form to join IMST and be listed in "Sex Therapist" Directory


Join a growing number of therapists that find this directory the best referral source for their practice.  You will be charged a renewable fee of $100/year.  You will find that this fee will more than be recovered in the first few months of your directory posting.  We are number one in most search engines for "sexual therapy" and "therapist's directory".  



Your name*:
Gender* (M/F):
Company:
Address*:
City*: State*:
Zip Code*: Country:
Telephone: Fax:
Email address*:
email address must be valid to place order
 
  

 



Back to Home Page

© 2011, Institute for Marital and Sexual Therapy. All rights reserved.



The information that you supply in the following five boxes will allow us to create a web page for you.

Please be a thorough as possible, do not be shy.  You have plenty of space.

Credentials and Affiliations (list up to six).


Specialty Areas and Services (list up to eight).


Notable accomplishments.


Current books in publications; do you have a current web site and what is the name?.


Comments : include any special ideas that you want on your web page, such as mission statement.

 

 

 
  

 



Back to Home Page

© 2011, Institute for Marital and Sexual Therapy. All rights reserved.


Back to Institute's Home Page

Copyright 2011