Christian Internal Family Systems Therapist Update Form

Please submit the form below to request addition or update of your information on our CIFST directory.

Please note that this form goes to the webmaster and not Kimberly June Miller.
Name*
First Last
Credentials*
Location
Do you maintain a waiting list?*
- Yes
- No
Do you accept distance clients?*
- Yes
- No
Do you accept out-of-state clients via video?*
- Yes
- No
Email*
Enter Email Confirm Email
Website
Phone
This field is for validation purposes and should be left unchanged.