Welcome to the PROVIDER application form for NAAAP-Chicago's Wellness Therapy Fund program (NWTF)!
The goal of this program is to make psychotherapy as available, accessible, and approachable as possible to the Asian community in the Chicagoland area.
The information on this form will only be used in connection with the work of the Chicago chapter of the National Association of Asian Americans (NAAAP-Chicago) and will only be accessible to designated individuals directly involved in this program (such as our Treasurer and Wellness Program Chair). Filling out this form does not guarantee immediate placement into this program. Please review our terms and conditions and fill out the form below. If you do not review and sign the terms and conditions, we are unable to accept your application.
In order to be considered for this program, you MUST be:
(1) a licensed mental health professional in the state of Illinois,
(2) able to provide culturally responsive clinical services to adults at least 18 years old*, and
(3) listed on CAATCH’s online directory. If chosen to join NAAAP-Chicago's Wellness Therapy Fund program as a provider, you will be partnering with NAAAP-Chicago to address our community's financial and cultural barriers to wellness.
Description of the NAAAP Wellness Therapy Fund:
Generally speaking, the selection process for this program operates on a needs-based and first-come, first-served basis. NWTF recipients will receive from NAAAP-Chicago financial assistance of up to $100 per session, for up to 8 sessions (at least 53 minutes in length) per application round. In order for individuals to continue receiving subsidized therapy, the recipient must reapply during each application round. Each NWTF recipient will receive a unique voucher code to help protect their identity. Providers are to notify NAAAP-Chicago via this unique voucher code when sessions have been attended so NAAAP-Chicago can pay providers directly for sessions rendered. NAAAP-Chicago will receive no other information about the sessions; NAAAP-Chicago is simply funding sessions attended.
Please note, agreeing to participate in the NWTF is not a guarantee that the recipients of the Wellness Therapy Fund will choose to work with you. Each recipient chooses which of the participating clinicians they feel most aligned. As with any therapy service, they also have the right to terminate services and/or change providers.
Thank you for your interest in helping NAAAP-Chicago further its mission of destigmatizing mental health for our community! Further information will be provided once your application has been approved and you’ve been accepted into the program.
*At this time, NAAAP-Chicago's Wellness Therapy Fund is available to IL residents 18 years and older only.
Is this your first time applying to be a provider for the NWTF - NAAAP Wellness Therapy Fund program?
Terms & Conditions: You confirm that you, as the individual submitting this form, are the named clinician intending to provide therapy services, that you are a licensed mental health professional in the state of Illinois, and that if you accept a client, that you are fully competent to provide clinical services in the areas of specialization likely needed to treat the client. If you are accepted to be a provider in NAAAP-Chicago’s WellnessTherapy Fund program, you are agreeing to accept NAAAP-Chicago Wellness Therapy Fund recipients as clients, when professionally appropriate. You will be accepting a maximum payment of $100 per session, for a maximum of 8 sessions per application round. Subsequent finacial assistance through the NWTF requires recipient reapplication.
You are agreeing to uphold your ethical, legal, and professional standards by providing quality care.You acknowledge that NAAAP-Chicago, its partners, and its sponsors provide no warranties and have no liability for any services provided by or any issues related to therapists. You acknowledge the CAATCH Therapist Directory is a non-exhaustive, voluntary listing of mental health professionals who are attempting to provide quality, culturally competent services but who are not endorsed by or are agents of NAAAP-Chicago. Therapists are solely responsible for adhering to their professional responsibilities and legal requirements, including HIPAA and other compliance and reporting obligations, and for carrying appropriate liability insurance. Each therapist participating in the NWTF program agrees to relieve and indemnify NAAAP-Chicago for all liability relating to participants or issues in this program. By clicking yes below, you acknowledge that you fully understand the terms and conditions above and, if selected as a clinician, freely consent to abide by all rules and policies associated with the NAAAP-Chicago.
A copy of your responses will be emailed to the address you provided.