Request to join

Thank you for your interest in Joining the PPC! Please submit this request for our review.

If you are requesting to join as an early career/pre-licensed clinican you must have a supervisor who is a PPC Member. Please list the name of your supervisor in the space provided. Pre-licensed requests without a listed supervisor will not be approved.

Please note that Affiliate Member requests are not being accepted at this time.

Upon approval you will receive a confimration email and link for payment. Please email us if you have any questions at [email protected]

* Required fields are marked with an asterisk

First name *

Last name *

Professional email *

Website

Clusters

Licensed in Massachusetts *

Other State Licensures

Early Career

Supervisor

Demographic Data

County in MA *

Credential Type *

Keep this blank

I give consent to The Private Practice Colloquium : Membership Platform to use this information to build a profile when my request is approved. *