International Practitioner Directory Registration

Please make sure to add james@drlaurenceheller.com and info@drlaurenceheller.com to your safe senders list in your email settings. All notifications and renewal information will be sent from these email addresses. If you do not receive a confirmation email after submitting this form, please check your spam and junk folders.

Photo	Optional. You can upload a photo of yourself. 300 pixels maximum width or height.
Name*	Full name, including title
Form(s) of Practice	i.e. Heilpraktiker für Psychotherapie, Psychotherapist, Koerperpsychotherapeut, Body Psychotherapy, Somatic Experiencing, Diploma in Psychology, Graduate-level Teacher, etc
Faculty?	Check this box if you are a NARM Faculty member.
Assistant?	Check this box if you are currently assisting in NARM Trainings. Please note this will require verification.
Certification*	Certification Certified Practitioner Master Practitioner Level of Practitioner Certification
Availability	Availability Sessions ZOOM Sessions Skype Sessions Teams Sessions Google Meet Sessions Online Sessions Single Consultations Group Consultations Walking Sessions Options for how your patients can meet with you
Languages	All languages you are fluent in and can have sessions with clients in this language
Street Address	Optional: Physical address of your practice where you see clients (Optional, but helps clients find someone nearest to them). Please use the complete address including city and country for google map implementation.
City*	City your practice is physically located in.
Country*	Country Australia Austria Belgium China Denmark England France Germany Greece Indonesia Ireland Italy Japan Lithuania Netherlands Norway Poland Romania Scotland Singapore Slovenia Spain Sweden Switzerland Wales Country your practice is physically located in
Webpage	Website for clients to find out more. Please use the full url, including http in the first box. Put the text you would like displayed for this link in the second box.
Email*	Public email for clients to contact you at
Phone	Your primary contact number
Personal Blog or Social Media Link	Optional. Not your main website. Put the URL in the first box and the link text that you want displayed in the second box