Submit Member Details

Hi folks,
This page is not accessible via menu from the website – it’s for members’ eyes only to submit details for inclusion in the directory. If you’ve any queries, please contact You will be able to edit your own details at a later date.
Please complete all parts of this form and click the submit button below.

    I am an accredited or full member of the IICHP and intend continuing as such for 2012. I have read, understood and accept the terms below. Please include me on the directory website.

    Terms of Use

    I understand that the website is intended to provide details of IICHP members' services on the internet. I will have control over the information published and that all information that I provide will be accurate and subject to review by the webmaster and the IICHP committee if necessary. Disclaimer: While maintaining ongoing reasonable moderation and user support, the website takes no responsibility for information available on the site and by partaking in the site I hereby indemnify IICHP and web developers from any loss or damage whatsoever that may arise directly or indirectly from the use of the site.

    First Name (required)

    Last Name (required)

    Email (required) [Note: this will NOT be published on the site, but the site will send notifications of interest to this address.]

    Phone for clients (optional - this will be published on the site)

    Contact Phone (required) [Note: this will NOT be published on the site]

    Name of practice (optional) [Note: this can be your own name or the name of a group or practice, e.g. "Insight House Counselling Services" or "Joe McBride"]

    Location of practice (required) [Note: this can a specific address, or an area only, e.g. "Happy House, 10 Good Lane, Smithfield, Dublin 7" or "Co. Meath"]

    Website Address (optional) [Note: this will be published on the site]

    Qualifications (required, e.g. "IICHP (Accredited Member since 2006); Diploma in CBT from DBS, Ireland, 2009.")

    No of years of Experience (required, e.g. "12 years practising")

    Areas if Interest (required, up to 200 words, e.g. "My speciality is working with adolescents and early school leavers with learning disabilities.... etc" )

    Background / Biography / About you and your service (required, up to 500 words, e.g. "Originally from a secondary school teaching background, I completed my IICHP diploma in 1999 to help me in my work with early school leavers... etc". Try and make this accessible and interesting - remember, you are trying to attract potential clients! Why should they choose you? )

    Rate per session (optional - this can be a specific amount or a sliding scale, e.g. "€50 per 50 minute session. Concessionary rates are possible under certain circumstances - please ask.")

    Mugshot (optional - please click "Choose File" to select a photo if you would like this to be included on your page. If you don't have one ready, you can submit this at a later time.)

    Any other Comments or Notes to the developer (optional - these will NOT be published)

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