ACCESS TO MENTAL HEALTH SERVICES

FOR URBAN NATIVES

REGARDLESS OF RECOGNITION STATUS

Looking for an Indigenous therapist?

Join our waitlist to be connected to ShockTalk!

🚀 Participants selected for our New York Pilot Program will be notified via email

ShockTalk Pilot | Client Sign Up

Name

First Name

Last Name

Who recommended ShockTalk?

Indigenous Affiliation

Please include Indigenous cultural affiliation(s), or Tribal affiliation(s). We recognize all Indigenous peoples, regardless of Federal status.

Current residence

Are you located in New York City?

Therapy seekers in New York City may receive an invite to our pilot program

Yes

ShockTalk Pilot | Provider Sign Up

Name

First Name

Last Name

What's the best way for us to reach out to you?

Phone

(###)

###

####

Who recommended ShockTalk?

Indigenous Affiliation

Please include Indigenous cultural affiliation(s), or Tribal affiliation(s). We recognize all Indigenous peoples, regardless of State or Federal status.

Do have an active clinical/professional/therapeutic/medical license?

Yes

State

Are you licensed in more than 1 state? If so, which states? If not, please respond N/A.

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