Consultation or Referral to a Candidate in Training

Please fill out this form if you would like to see a candidate in training for psychoanalysis.

Please note that MIP is not an emergency service and it may take us a few days to respond. If you need immediate help, please call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained crisis counselor.

Referral Form to work with a Candidate in Training

Name(Required)

First Last

Email(Required)

Phone(Required)

Is location important for treatment, and if so, where is your preference? (optional)

Please tell us why psychoanalytic therapy is being sought at this time. (optional)

Do you have a preferred gender of your therapist or accessibility/language requirement? (optional)

How did you hear about MIP? (optional)

If you will need insurance coverage for treatment, please select the type: HMO, PPO, or POS (optional)

This is optional, but by providing your insurance information will enable us to help you find a better match (i.e., someone who takes your insurance).

Is there any additional info you would like to add to your request?

Referral Form to work with a Candidate in Training

MIP Candidates in Training who are accepting control cases

Massachusetts Institute for Psychoanalysis