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Therapist Network:
Thank You for Your Interest in Joining Arielle's Light

He/Him, She/Her, They/Them

(e.g., Licensed Therapist, LMFT, LCSW, Psychologist...)

Do you currently accept clients via telehealth?
Yes
No
Do you offer in-person sessions?
Yes
No
What populations do you serve? (Check all that apply)
Do you have experience working with underserved or marginalized communities?
Yes
No
How many clients would you be open to seeing through our referral network each month?
1–3 clients
4–6 clients
7+ clients
Are you open to offering a discounted rate for clients referred through Arielle’s Light?
Yes
No
Do you offer a sliding scale rate for clients based on financial need?
Yes
No

  • I understand that all therapy rates must be agreed upon in writing with Arielle’s Light before sessions begin.

  • I agree to bill Arielle’s Light directly for approved sessions at the predetermined rate and acknowledge that sessions conducted without prior written agreement will not be covered.

Your bio and photo will help us highlight your expertise and services to individuals seeking care through our network. Do you give Arielle's Light permission to feature your bio and photo on our website once approved?
Yes
No

  • I confirm that I am a licensed mental health professional in good standing with my licensing board and agree to uphold ethical standards and best practices in mental health care as required by my licensing board and industry guidelines.

  • I confirm that I have the training and experience needed to provide compassionate and effective care for minors.

  • I understand the importance of adhering to all state and federal laws when working with minors, including mandatory reporting, parental consent, and confidentiality guidelines.

  • I acknowledge that the treatment of minors is solely at my discretion, and I will follow all applicable state and federal parental consent guidelines.

  • I agree to hold harmless Arielle’s Light for any decisions, actions, or outcomes related to my treatment of minors, ensuring full compliance with all relevant laws and ethical standards.

  • I will maintain detailed documentation and follow all child protection laws to ensure the safety and well-being of the children I work with.

  • Arielle’s Light serves as a financial facilitator only and does not provide or oversee therapy services directly.

  • Therapists operate as independent practitioners and are fully responsible for their own professional conduct, treatment approaches, and compliance with licensing laws and regulations

  • Arielle’s Light does not guarantee a specific number of referrals, outcomes, or specific results from therapy services provided through this program.

  • Any issues, disputes, or concerns related to therapy services must be addressed directly between the therapist and the client.

We are excited to collaborate with compassionate and skilled therapists like you to provide life-changing support to those in need. Please complete the application below to apply for inclusion in our network. Your role in creating positive change is deeply valued.

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