How would you like to join?

Choose the option that best describes you. All members agree to our Statement of Faith.

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Healthcare Provider

Physician, PA, NP, counselor, psychologist, biblical counselor, or other clinician

✝

Church

A congregation that affirms our approach to faith and medicine

🤝

Supporting Member

You agree with the mission and want to stay connected, but prefer not to be listed publicly in the directory.

Your contact information

We'll use this to reach out if we have questions about your application.

Full name *

Please enter your full name.

Email address *

Please enter a valid email address.

Phone number

Optional — only used for application follow-up if needed.

Your practice details

This information will appear on your public listing (if you choose to be listed).

Credential type *

Please select a credential type.

Specialty *

Please select a specialty.

Practice name

Leave blank if you prefer not to list a practice name.

Practice address *

Used to place your pin on the directory map. Full address or city/state is fine.

Please enter your practice location.

Contact email for referrals

If different from your personal email. This is shown to people who want to contact you through the directory.

Practice website

Languages spoken

List all languages. English is assumed if left blank.

In-person appointments

I see patients at a physical location

Telehealth available

I offer virtual / telehealth appointments

Brief bio *

0 / 1000 characters

Please write a brief bio (at least 20 characters).

Your church details

This information will appear on your public listing (if you choose to be listed).

Church name *

Please enter your church name.

Denomination / tradition

Pastor / contact name

Church address *

Used to place your pin on the directory map.

Please enter your church address.

Church website

Biblical counselor on staff

Our church has a certified biblical counselor on staff

Your approach to faith & medicine *

0 / 1000 characters

Please write a brief description (at least 20 characters).

A little more about you

Supporting members aren't listed publicly — you'll receive FMF communications and be counted in our network.

Your role

Visibility & agreement

Choose how you'd like to appear in the directory, then review and agree to our Statement of Faith.

List me publicly in the directory

Your profile will appear on the map and list view, visible to anyone visiting the directory.

Supporting member only (private)

You won't appear in the directory. You'll receive FMF communications and be counted as a member.

Statement of Faith

Please read our Statement of Faith (PDF) before agreeing. Membership in the FMF network requires agreement with this statement.

I have read and agree to the FMF Statement of Faith. *

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Application received!

Thank you for applying to join the Faith & Medicine Foundation network.

Our team will review your application and you'll hear back from us at the email you provided. If you have any questions in the meantime, reach us at office@faithandmedicine.foundation.

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