TransCEND Trans-Affirming Provider Questionnaire
Thank you for your interest in being listed as a trans-affirming service provider on the TransCEND Canton website. Please complete the following form with information regarding your facility, documentation, experience and education.
We strive to ensure that the providers/services listed on our website are trans-affirming, not just “trans-friendly” or “accepting of all.” We understand that providing a trans-affirming experience from the moment the client finds your name to termination of services can be difficult. If you find that your practice/service is not trans-affirming (yet) feel free to reach out to us! We’re happy to consult with you to create a trans-affirming environment and experience.
If you need assistance regarding this form, please send an email to
Provider Name (if different)
Provider Services (ex. HRT, MTF Gender Affirmation, etc.)
Please provide full address(es) and phone number(s).
Have you worked with transgender patients?
Never submit passwords through Google Forms.
This form was created inside of TransCEND, Inc..