There are 2 mandatory steps required before completing this registration form. Please note that you must be a current WMHCA member with a public profile to be listed in the registry.
- Download this form and sign and complete the form.
- Complete the online form below and upload the signed form into the field below, or mail the completed form to:
11410 NE 124th St.
Kirkland, WA 98034
Clinical Supervisors must meet requirements by the state of Washington, REVIEW REQUIREMENTS HERE