Resource Directory Listing Please enable Javascript in your browser or use a different browser to complete this application. Click here to learn how to enable Javascript. ConId OrgId DLId Update?YesNoOrgAffiliate Already a Premium MemberYesNo Welcome to ATN’s Resource Directory Listing Intake Form.Thank you for joining ATN's Directory. It will be seen by thousands of families across the country (and world).Complete the application in one sitting. Leaving this page will delete your work.Questions? Email us at directory@attachtrauma.org What level of directory listing are you completing? Pro Membership – $100/annually Organization Membership – $250/annually Premium Listing In-depth questions about your practice Your photo Symbol designating “ATN Member” next to listing Listing comes to top of search Discounts on ATN products Access to Members Only content Certificate/window cling to display in your office And more Premium Listing like Pro Member, plus: Logo and listing by Organization Name Ability to upload videos and link documents Individual professional listings/photos for key staff members Links to social media Discounts on ATN products Access to Members Only content Certificate/window cling to display in your office And more Free Listing – select choice below to fill out free listing What level of directory listing would you like?Organizational Membership - $250/yearPro Membership - $100/yearFree Listing Please complete this form for your Org only. We'll email you a link for your Key Staff profile pages. Your Information First Name Last Name Phone Email Professional Designation (Post-Nominal Letters Only)(if applicable) Professional letters at the end of your name should go here. Anything else should go below under Certfications/Accreditation. Organization Information Organization Name Website Listing Location Street Address City State/Province (Put N/A if not applicable) Zip / Postal Code CountryPlease select... 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(Pick one) Therapists/Counselors Treatment Programs Psychiatrists Neuropsychologists Other Therapies Family/Caregiver Support Special Education Resources Trauma-Informed Schools Resources Category descriptions:Therapists/Clinicians: (LMFTs, LPCs, LCSWs & others treating trauma-impacted clients) Treatment Programs: (RTCs, PTRFs, wilderness programs, retreats, therapeutic boarding schools & day programs) Psychiatrists (include neurologists and other prescribing MDs) Other Therapists (OTs, speech, PTs, neurodevelopmentalists, equine & others) Family/Caregiver Support: (respite, support groups, coaching, ed consultants) Special Ed Resources: (advocates, attorneys, IEP support) Trauma-Informed Schools Resources: (PD training, consulting, school system change) Resource Attributes (select all that apply) Types Occupational Therapist Speech & Language Professional Physical Therapist Equine Therapy Program Neurodevelopmental Practicioner Other Types Residential Treatment Center PTRF Retreat Centers Wilderness Program Therapeutic Boarding School Day Program Types Respite Providers Crisis Support Parent Coach/Trainer Educational Consultant Support Groups Non-Profit organization Legal Services Types Special Education Advocate Special Education Attorney Advocacy Organization Parent Training Institute (PTI) Protection & Advocacy Organization (PAO) Disability non-profit Organization ModalitiesARC - Attachment, Regulation, CompetenceBrainspottingCircle of SecurityCPP - Child-Parent PsychotherapyDBT - Dialectic Behavioral TherapyDDP - Dyadic Developmental PsychotherapyEFT - Emotional Freedom TechniquesEMDRInterpersonal NeurobiologyIFS - Internal Family SystemsNeurofeedbackNMT - Neurosequential Model of TherapeuticsPCIT - Parent-Child Interaction TherapySanctuary ModelSomatic ExperienceTBRITF-CBTTheraplayTRM/CRM ModalitiesAnimal TherapyArt TherapyMusic/Dance TherapyDramaDrummingEFT - Emotional Freedom TechniquesEquine TherapyHippotherapyNeurodevelopmental ReorgNeurofeedbackSensory IntegrationSomatic Experience Issues Adoption Developmental Trauma Disorder Reactive Attachment Disorder Disinhibited Social Engagement Disorder FASD Dissociative Identity Disorder Depression Anxiety Self‐Harming Sexual Abuse Sexualized Behaviors Gender Identity Issues Grief Medical Trauma Racial Trauma PTSD Aggression/Homicidal Tendencies Autism & Trauma Bullying Intellectual Disabilities & Trauma Substance Abuse Sensory Processing Disorder Services Individual Therapy Family Therapy Group Therapy Parent Coaching In-Home Services Intensives Telehealth/Online Therapy Support Groups Public Trainings School Consultations Expert Witness Christian Counseling Services Parent Coaching In-Home Services Public Trainings School Consultations Online/Telephone In-person Services Consultations Advocacy Other Services Public Trainings Attend IEP Meetings IEP Support Special Ed Law Parent Training Public Training/Information Pro bono Work Negotiation/Mediation Technical Assistance Services Consultations In-person PD Training Online PD Training Consulting/Coaching Policy & System Change Services School Consultations Expert Witness Evaluations/Testing Topics Trauma Impact on Learning ACEs Trauma-informed Policies and Systems Cultural Competency Racial Trauma Trauma-informed Special Ed Restorative Practices Focus Ages ServedYoung Child (preschool)Child (ages 5-11)Pre-teen/Teen (ages 12-18)Young AdultsAdultsElderly (60+) Client FocusMaleFemaleNon-BinaryLGBTQ+BIPOC Payment Payment TypesInsuranceMedicaidSelf-PaySliding ScaleMedicare Insurance Types Accepted Pro Listing Information My/Our Approach to Healing Specific Issue(s) I/We are Skilled at Helping With What Makes My/Our Work Trauma-Informed & Attachment-Focused Upload a Photograph/Company Logo to display on your company profile Would you like an introductory video on your profile? Enter the link here We recommend uploading the video on a free service such as Youtube or Vimeo If you would like to link out to any collateral, enter that URL here Facebook Profile Link Twitter Profile Link Instagram Profile Link LinkedIn Profile Link Click on the "Submit" button below to proceed to the next screen where you will be able to pay the membership fees via Paypal. Paypal_Hidden_Fields By submitting, you will also receive ATN's monthly newsletter. Please complete this form for your Org only. We'll email you a link for your Key Staff profile pages. reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA.