Postpartum Resource Center of New York's
Perinatal Mood and Anxiety Disorder
State-wide Resource Directory

Online Application

To be considered for inclusion in the Directory, kindly return this form completed with the supporting documentation requested. Your application will be reviewed and you will be notified of our decision. Inclusion in the Directory is not an endorsement by the Postpartum Resource Center of New York, Inc. of your business or services.

Please complete all fields below and then submit when you are done. The asterisk (*) notes fields that are required to be completed before you may submit your application.

If you have any questions, please feel free to contact us here.

You may also download the Directory application below (pdf) and mail it completed to us with supporting documentation.


If "Other", please specify here.
In addition to English, please list any languages you speak and/or read and write.
Please include any other relevant information here.
If "Other", please explain below.
If your payment option is "Other", please explain here.
If yes, please upload a copy of your license below.
Your file will be uploaded once you complete the form and submit the application.
If yes, please explain below.
Please use space above to explain any license suspension or revocation.
Your file will be uploaded once you complete the form and submit the application.
Your file will be uploaded once you complete the form and submit the application.
Thank you for your application to the Postpartum Resource Center of New York, Inc.'s Perinatal Mood Disorders Resource Directory. Your application will be reviewed and we will notify you of our decision.

I understand that inclusion in the Directory is not an endorsement by the Postpartum Resource Center of New York, Inc. of my business or services.


Postpartum Resource Center of New York
Perinatal Mood and Anxiety Disorders:
Finding the Help you Need.
Serving New York State families since 1998


In New York State please
email us or call
State-wide Helpline:
Toll free: 855-631-0001
631-422-2255

Hablamos Español
For help outside of New York State and the United States,
please contact the Postpartum Support International.
The information on this site is not intended to diagnose or treat any medical
or psychological condition. Please consult your doctor for individual advice
regarding your own situation.
The Postpartum Resource Center of New York, Inc.
is a not-for-profit, 501(c)(3) tax-exempt organization.
All Rights Reserved. Copyright ©1998-2017
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