User account

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Confirm e-mail address: *

Please re-type your e-mail address to confirm it is accurate.

Password: *

Confirm password: *

Please choose a password for your account; it must be at least 6 characters.

Address

First name: *

Last name: *

Company:

Street address 1: *

Street address 2:

City: *

Country: *

State/Province: *

Postal code: *

Phone number:

Professional Information

Display Name:

The way you want your name to appear in the directory.

Company Name:

Street 1:

Street 2:

City:

State:

Zip Code:

Phone:

Fax:

Website:

example: www.utahplaytherapy.org

Email Address:

If you don't have a website you may publish your email address here. This is optional example: you@somewebsite.com

Degree(s):

Primary License/Certification:

Discipline:

Play Therapy Credential:

Provides Supervision/Case Consultation

Opt-In to Public Search

Check this box to opt-in to the public therapist search. This must be checked AND you must be a current member of UAPT to be listed. The content of this field is kept private and will not be shown publicly.

County:

The county where your listing should appear.

Newsletters

Subscribe to Utah Association for Play Therapy newsletter

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

User account

Upcoming Events