Joining the Affiliate Program

Annual Membership Fee: $1000
Annual Group Membership—3-5 Associates $2500

I would like to become an Affiliate Member of The Center for Transformational Psychotherapy. I am in agreement with the CTP Mission Statement and will conduct my ketamine practice within that framework. Please include me on the CTP Practitioner Referral List. My fee has been paid.

Name*
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Office Address*
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Office Telephone*
Office Fax
Office Email*
Website
Personal Contact info (for CTP use only)
Type of Membership*
- Individual
- Group
Annual Individual Membership*
Price:
$1,000
Annual Group Membership*
Price:
$2,500.00
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
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Joining the Affiliate Program

Annual Membership Fee: $1000 Annual Group Membership—3-5 Associates $2500

Annual Membership Fee: $1000
Annual Group Membership—3-5 Associates $2500