Account Details Username (required)Email Address (required) Choose a Password (required) Strength indicator Confirm use of weak password Confirm new password Hint: The password should be at least twelve characters long. To make it stronger, use upper and lower case letters, numbers, and symbols like ! " ? $ % ^ & ). Profile Details Name (required) This field may be seen by: Everyone License Number (required) This field may be seen by: Only Me Zip Code where you live (required) We're interested in knowing your community and helping you connect. We won't share this personal information. This field may be seen by: Only Me License Type (required) ----LCSWLMFTLPCPhDPsyDMD/DOLMHCAPSWLPCAPLPCAMFTOther Please select license. If "other" is selected, one of our team members may be in touch for more information. At this time Caret Care Collective is restricted to licensed and practicing behavioral and mental health professionals. This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close What States are you licensed in? (required) This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close Specialties This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close Telehealth available? (required) YesNo This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close Anything else you want to tell us? List additional credentials here or add any other registration information. This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close State of Residence (required) This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close
