NOW ACCEPTING LETTERS OF INTENT

Become a TheraPlug Founding Provider

Become a TheraPlug Founding Provider

Help expand access to behavioral healthcare. Express your interest in joining TheraPlug’s founding provider network by completing this short, nonbinding Letter of Intent.

Help expand access to behavioral healthcare. Express your interest in joining TheraPlug’s founding provider network by completing this short, nonbinding Letter of Intent.

Submitting this form does not commit you to joining or guarantee acceptance. We will collect additional credentialing information during onboarding. Participation is subject to credential verification and a separate provider agreement.

1. CONTACT INFORMATION

2. PROFESSIONAL LICENSE

3. PRACTICE INTERESTS AND AVAILABILITY

Areas of clinical focus — Optional; select all that apply

Age groups served — Optional; select all that apply

4. LETTER OF INTENT

I am interested in exploring participation in TheraPlug’s founding provider network. The availability provided above is an estimate for planning purposes. This Letter of Intent is nonbinding and does not create an employment, contractor, exclusivity, or service obligation. Participation would require credential verification and a separate, mutually accepted provider agreement. Compensation and other participation terms would be addressed in that agreement.

TheraPlug will contact you about your submission regardless of whether you select optional news updates.

Please do not submit patient information, Social Security numbers, banking details, or identity documents through this form.

Privacy Policy link still needs to be provided.

What Happens Next?

1. We receive your expression of interest.

2. Our team reviews your professional background and availability.

3. We contact you about potential next steps.

4. Selected applicants complete credential verification.

5. Approved providers review a separate provider agreement and complete onboarding.

Questions Before You Apply?
Our Provider Relations team is ready to help.

Questions Before You Apply?
Our Provider Relations team is ready to help.

providers@theraplug.health

providers@theraplug.health

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