Health Professional Listing Sign Up

ATA's Health Professional Listing helps tinnitus patients across the country reach out to local health care resources. While the lists are not a formal referral service, and ATA does not endorse or recommend any treatment strategy, these lists are provided to ATA members who seek suggestions when making health care choices.

If you are a health care professional with sincere understanding of tinnitus and its many treatments, please submit the following form to be considered for the listing.

An annual donation of $35 or more ($50 outside the United States) includes ATA's magazine, Tinnitus Today - an informative addition to any office or clinic waiting room. If you have any questions, please contact ATA or call (800) 634-8978, x 219 for additional information.


Please select one:

New Health Professional Listing
Update Health Professional Listing

Title
E-mail
First Name
Last Name
Address Line 1
Address Line 2
City
State
Zip 
Country (if outside U.S.)
Company/Clinic Name
Applicable Degrees
License #
License State
Fax
Web site 
Telephone
   
What is your professional specialty? Please check all that apply.
Medical Doctor Please specify:
ENT/Otolaryngologist
Psychiatrist Other:

Audiologist

Graduate Level Professional Please specify:
Psychologist Dentist
Other:

 Hearing Instrument Provider

Please check the tinnitus-related Evaluation Services you provide.

Audiological Evaluation ENT Evaluation
Hearing Instrument Evaluation Medical Evaluation
Psychiatric Evaluation Psychological Evaluation
Team Approach  
Please check the tinnitus-related Therapeutic Services you provide.
Acupuncture Biofeedback
Cognitive Behavioral Therapy Counseling
Electrostimulation Hearing Aids
Hyperacusis Treatment Hypnosis
Musculoskeletal Approaches Masking
Nutritional Approaches Pharmacological Approaches
Psychiatric Treatment Sound Therapy
Surgical Approaches Temporomandibular Joint Disorder (TMJ)
Other Pulsatile Tinnitus Treatment


Get involved with the American Tinnitus Association by speaking to a support group in your area:

I am willing to speak to a local support group.

Please read carefully before submitting.

By requesting to be included in the American Tinnitus Association's Tinnitus Health Professional listing:

- I affirm that I have an interest in helping patients with tinnitus and agree to offer them support and information on treatment options that may provide relief.

- I agree to refer colleagues with an interest in tinnitus to the American Tinnitus Association.

- I agree to stay informed on current tinnitus research through professional journals and Tinnitus Today, and to attend continuing education seminars in the tinnitus field where available.

Applicant understands and agrees by submission of this application, that ATA reserves the right, in its sole and individual discretion, to reject any application or remove any applicant from any Health Professional List at any time for any or no reason, notwithstanding that ATA may have previously accepted the same or a similar application and placed applicant's name on a Health Professional List.


Pressing the Submit button will process your list request and return you to the About Tinnitus home page.