Skip to main content

Submit a Bio

Use the form below to submit information for your team profile page on the website. We feature patient-facing staff on the website under each office location. Once you submit your bio, it undergoes a review process by the marketing team. Please allow for up to two weeks for review/approval of your new bio. If you have any questions contact adeliel@elitedna.com and jzencka@elitedna.com.

"*" indicates required fields

You may list any and all universities or colleges you have attended. i.e. Colgate University, Yeshiva University – the Ferkauf Graduate School of Psychology, NYU Psychoanalytic Institute
You may list your degree, such as Doctor of Clinical Psychology (PsyD), M.S. in Clinical Mental Health Counseling, B.A. in Psychology, M.A. in Health Counseling, Marriage and Family Therapy
Certifications
i.e. Qualified Supervisor, Wraparound Facilitator and Coach, Certified Clinical Trauma Professional, Board-Certified in Child, Adolescent and Adult Psychiatry
Affiliations
i.e. National Association of Social Workers, National Board for Certified Counselors, American Psychological Association, American Psychiatric Association
Location You Work At*
Please select the location you work at. If you cover multiple offices, be sure to select each here.
Services You Offer*
Please select ALL services you offer in addition to telehealth.
Specialities*
We will use your photo from orientation. If you were not able to attend orientation, please submit a photo where this is good lighting, and space from shoulder to edge of photos.
Accepted file types: jpg, jpeg, png, webp, Max. file size: 5 MB.

Hit enter to search or ESC to close