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  • Your Info

  • Agency or Organization (if applicable)
  • License Information

  • Interns (Supervisor Info, if Applicable):

  • Contact Info

  • Email

    Your address will only be used for within group contact and to subscribe you to our listserv. Once you are added to our email list, please send your introduction/bio to the group so that we know about you and your work and we can welcome you:
  • This is for internal use only; your email address will not appear on your profile page.
  • Please format website address as: http://www.yourwebsitehere.com. *Site listings are for Psychotherapy Services ONLY! You must either be licensed to provide those services or you should be able to list your supervisor's license under which you practice mental health and counseling services.
  • Required phone number format: (###) ###-####
  • Work/Office Address:

  • About Yourself

  • Site listings are for Psychotherapy Services ONLY: You must either be licensed to provide those services or you should be able to list your supervisor's license under which you practice mental health and counseling services.
  • Upload Picture will render square after the upload - do not worry if the picture looks cropped here. Photos uploaded should be SQUARE for best results. Pictures should be uploaded only in the .jpg or .png file type. Recommended image size should be 250px by 250px. If you photo is not uploaded correctly, you may need to reduce the file size of the image to less than 64MB.
    Select one.
  • This is a searchable field, please select the options that best apply. Ctrl+Mouse Left Click to select more than one option at a time. (Or Command + Click)
    We strongly encourage 2 hours/year of volunteer time.
    Please check all that apply.
  • This is a searchable field, please select the options that best apply. Ctrl+Mouse Left Click to select more than one option at a time. (Or Command + Click)
  • This is a searchable field, please select the options that best apply. Ctrl+Mouse Left Click to select more than one option at a time. (Or Command + Click)
  • This is a searchable field, please select the options that best apply. Ctrl+Mouse Left Click to select more than one option at a time. (Or Command + Click)
  • While you may work with diverse clients, we want to be sure you are also committed to working with kink and poly identified folks. **For internal use only. Will not be published in the directory.**
  • Minimum length of 7 charactersStrength indicator
    Please select an option below to register. If you choose to pay with PayPal your member profile will be activated once it is manually approved by the administrator. You may also register and pay by check (Select Manual/Offline), but your membership will take longer to process. Your membership profile will be saved as a draft until a check is received by Bay Area Open Minds, at which point the website administrator will manually approve your profile and activate your listing.
  • Pay by PayPal or By Credit Card

    - $35.00 / 1 Year
    Licensed Members
    - $25.00 / 1 Year
    Students, Trainees & Interns
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      Billing Details

  • Annual Membership Fee: $35 Licensed Members; $25 Students, Trainees & Interns

    Please make check out to: Open Minds
    Memo: Membership Fee
    Mail to:
    Open Minds
    c/o Diana Gordon
    870 Market Street, Suite 958
    San Francisco, CA 94102