Practitioner Directory Application Please enable JavaScript in your browser to complete this form.Practitioner Directory Application APPPAH's Exclusive Global Directory for Prenatal & Perinatal Practitioners and Educators. The practitioners on this list have specialized education and training in the area of preventing and healing trauma from Prenatal and Perinatal influences. Qualifications for a listing on the Directory: APPPAH Member (Community or Premiere Level) Graduate Certificate from APPPAH's Prenatal and Perinatal Educators (PPNE) program or have received equivalent PPN education/certification For PPN Educators: Any graduate of APPPAH's Prenatal and Perinatal Educator Program (PPNE) certification program can apply for a listing as an Prenatal and Perinatal Educator and would be qualified to teach a class, give a presentation or be a consultant. For more information about the PPNE certification program visit this link: https://birth-psychology-classwomb.teachable.com/p/ppne-educator-certificate-program/ For PPN Practitioners: If you would like to be listed as a Prenatal and Perinatal Practitioner, you must submit documentation showing your additional training or certification as a therapist, counselor, bodyworker, birthworker, or other practitioner field. You will be solely responsible for any liability with the client. If you would like to request a listing on the Directory, please submit the form below and sign the agreement. If you have any questions, please let us know. Thank you! Catherine Lightfoot, Education Director edu@birthpsychology.com Audrey Miles-Cherney, Admin Director admindirector@birthpsychology.com The name and photo associated with your Google Account will be recorded when you upload files and submit this formFull Name and Credentials (as you would like it to appear) *Email address (best one for APPPAH to communicate with you) *Are you an APPPAH Member at the premiere membership level? *YesNoI'm not sure, I would like to know moreBrief description of who you are and what you do (approximately 50 words) *Please select which type of listing you are applying for (may select more than one) *Prenatal and Perinatal Educator (PPNE)Prenatal and Perinatal Practitioner (please upload supporting documentation in next section)Practioners: please select the professional category you wish to be tagged in (optional. These will be searchable fields, within the PPN Practitioner List)Medical ProfessionalBirth/Postpartum ProfessionalMental Health ProfessionalBody Work ProfessionalHolistic Health ProfessionalEnergy Work ProfessionalOtherOtherAdditional Practitioner documentation (if you selected Practitioner above). Please upload certifications for additional training relating to the category of practitioner you wish to be included in. This is for internal verification purposes only and will not be shared with anyone outside of APPPAH staff and board. Click or drag a file to this area to upload. Website to be published with your listing (required): *Location in City, State, Country format (required) *Email address to be published with your listing (optional):Phone number to be published with your listing (optional):Please select which items apply *I offer online appointmentsI offer phone call appointmentsI offer in person appointmentsPlease submit a photo to be used on the Directory. We request a High Res JPEG format. * Click or drag a file to this area to upload. Electronic Signature: By typing my name in the box below, I agree to the terms and conditions listed in this application, agreement and waiver. * Submit