Members of the
South Plains Association of Psychologists are provided with a free listing in our
consumer search engine which is available to consumers who visit our site.
Please complete the following form so that we can list you in the professional
database that will be
located on our site. You must be a member of the association in order to qualify
for a listing.
Business Address
Business Name
City State
Zip Code
Business Phone
Business
Fax
Location of Office in City (S,N,E,W, Central)
Any Languages other than English
Email Address
List on your web page Yes: No:
Any Special Hours (after 5, weekends)
Professional Position/Affiliation
Date Awarded Highest Degree
Conferring Institution
Professional Memberships
Please check professional organization membership
American Psychological Association
Texas Psychological
Association
National Association of School
Psychologists
Texas Association of School
Psychologists
Other Memberships
Optional Information for the SPAP Database.
Employment Setting (check one): Public School
Private School
Residential
Institution
Private
Practice State Funded Institution
College/University
Other
Primary Position (check one):
School Psychologist
Psychological Examiner
Clinical Psychologist
Counselor
Consultant
Counseling Psychologist
College/University Trainer Other
Primary Areas of Interest:
Private Practice
School I/O
Academia
Research
Public Service
Families Prevention
Ethnicity: American Indian or
Alaskan native
Black/African-American
Asian-American or Pacific
Islander
Hispanic/Mexican American
Puerto Rican
White/Caucasian Other
Gender Male Female
Areas of Clinical Expertise (Please check all that apply)
ADD/ADHD Anxiety Biofeedback
Career Chemical Dependency
Codependency
Depression
Divorce Recovery Eating Disorders
Forensics/Legal Gay/Lesbian/Bisexual
Issues
Geriatrics/Aging
Grief/Loss/Death
Issues
HIV Positive Issues Hypnosis Infertility
Manic Depression Men's
Issues
Neuropsychological
Testing Pain
Management
Panic
Attacks Parenting Skills Phobias
Physical Abuse/Violence
Post Traumatic Stress
Psychological Testing
Sexual Abuse Survivors
Sexual Issues
Sleep Disorders Sports Psychology
Step-families
Weight Management
Women's Issues
Populations Served (Please check all that apply)
Children
(4-12) Adolescents
(13-17)
Young
Adults (18-22) Adults
(23-65)
Older Adults (65+) Couples (opposite sex)
Couples
(same sex) Groups
Women Only Men Only
Define your specialty(s) (limit to 75 words)
Any special office policies (limit to 75 words)
Any past or current college affiliation(s) (limit
to 100 words)
Continuing Education or specialized skills (limit to 75
words)
If you already have a practice web site please enter the
address below:
Response Method (if you need additional information or want
to advise us of the best way to contact you):
Please call Send Email Send
surface mail
Please enter any text message below if you have questions or
need other information. It will be sent to us:
