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Join the Health Care Provider Directory

To register you and your practice with NPF’s Health Care Provider Directory, fill out the form below.

If you have any questions about our directory, visit our FAQ page or contact us at pnclead@psoriasis.org.

About You

First Name *

Middle

Last Name *

Designation (ex: M.D.) *

Credentials (ex: American Board of Dermatology) *

Email *

Password *

How do you gender identify? *

Female

Male

Gender Diverse

I prefer not to say

Specialities (please select all that apply) *

Dermatology

Mental Health

Naturopath

Pediatric Dermatology

Pediatric Rheumatology

Pustular Psoriasis

Primary Care

Rheumatology

Skin of Color

Are you taking new patients? *

Yes

How many patients with psoriatic disease do you see a week?

N/A

None

1-5

6-10

11-15

More than 15

Philosophy of Patient Care

Practice Information

Practice Name *

Address 1 *

Address 2

City *

State *

Zip/Postal Code *

Country *

Practice Phone *

Practice Email *

Practice Fax

URL

Office Manager’s Name

Office Manager’s Email

Type of Practice

Group Practice

Solo Practice

Employed Physician Practice

Does your practice provide Telehealth services?

Yes

Languages spoken at the office (please select all that apply)

Arabic

Chinese (Cantonese)

Chinese (Mandarin)

English

French

German

Italian

Japanese

Korean

Polish

Portuguese

Russian

Spanish

Tagalog

Vietnamese

Treatments

Oral Systemics

Phototherapy

Biologics

Other

How many patients with psoriatic disease does your practice see a week?

N/A

None

1-5

6-10

11-15

More than 15

Payment Methods

Cash / Credit

Medicaid

Medicare

Private Insurance

Sliding Scale

Clinical Trial Participation

Psoriasis clinical trials

Psoriatic arthritis clinical trials

Conflict of Interest Policies

Terms and Conditions

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