Practitioner Directory Submission

Basic Practitioner Info

First Name *

Last Name *

Phone *

Email *

Website *

Instagram Handle

Facebook Username

LinkedIn URL

TikTok Handle

Google Business Profile (Reviews Link)

Location Info

Postal Code *

City *

State *

Practice Details

Modalities Offered (Select All that Apply) *

Session Format *

Short Bio/Description *

Trust & Verification

Certifications/Credentials *

Upload Headshot

Information Consent *

I confirm that the information I have provided is accurate to the best of my knowledge. I grant HALO permission to review, edit for clarity or formatting, and, if approved, publicly display my name, services, location, website, and practice details within the HALO practitioner directory. I understand that submission does not guarantee approval and that HALO reserves the right to approve, decline, update, suspend, or remove listings at its sole discretion.

Directory Communication Consent *

I consent to receive email communication from HALO regarding my application status, approval decisions, listing updates, renewal reminders, administrative notices, and directory-related information. I understand that I may unsubscribe from non-essential communications at any time.

By submitting this application, you agree to HALO’s Privacy Policy and Terms of Service.