Create New Account

Accounts on CounselingTechnology.net are free, with the expectation that you must provide accurate information about yourself and your interest in the site.

For professionals: By providing full information about your area of specialization (what you are trained in) as well as your institutional affiliation (where you work or study), you help support the credibility of others who use this site for research and communication with the public.

Allow 3 minutes to complete this form. Thanks for your patience!

Create New Account

Choose a username:
(May have up to 20 letters and numbers, but no punctuation marks.)

Choose a password:
(Up to 20 letters and/or numbers; more is better.)

Re-enter password:

Please type your full legal name, or the full name of the principal investigator.
(Required.) [Privacy Policy]

Last name:

First name:

Middle initial (optional):

Academic credentials, certifications and licensure
(E.g. M.A., Ph.D., LPC, NCC etc.)
Optional but strongly encouraged:

E-mail address: [Privacy Policy]

Please re-enter your e-mail:

Please indicate your professional status:

Graduate student in a counselor preparation program

College or university professor/lecturer in a
graduate program that prepares professional counselors
(i.e., "Counselor Educator")

State-credentialed professional
(e.g., LPC, LMFT, LCSW, certified school counselor)

Practitioner exempt from state licensure

Consultant or curricular specialist

Other role:

Please describe your practice specialization:

K-12 school counseling

Postsecondary advisement, student personnel or related

Mental health counseling

Counseling or Clinical Psychology

Social Work (any setting)

Marriage and family therapy

Rehabilitative, addictions or offender counseling

Other specialty not listed above, or pertinent ACA division if a member:

Where are you? (Required.)

What is the name of the practice/agency/school where you work or study?

Location: (city/state or country)

Pick the statement that best describes you:

My primary professional identity or program of graduate study involves a Counseling or related field, as described accurately above. (Establishes elibigility to use the free survey distribution service.)

I am not a Counseling professional, but would like to create an for the following reason: (Please describe your interest in the site)

Reason: (Please describe.)

Please check your agreement with the following terms of service:

I agree I certify that all information I have provided is accurate. I will adhere to the ACA Code of Ethics when using this web site for research purposes and when communicating with the public. If I am distributing surveys in a public school setting, I will adhere to the ASCA Code of Ethics and observe all applicable local, state and federal laws governing distribution of surveys to minors. I acknowledge responsibility for my proficient use of this site, and agree to notify the administrator of any technical problems encountered.
Please note: New accounts will become activated upon response to confirmation e-mail, and will be reviewed by the website administrator the next business day. Please check your name and work setting information before submitting form; thank you.

Choose a username: (May have up to 20 letters and numbers, but no punctuation marks.)
Choose a password: (Up to 20 letters and/or numbers; more is better.)
Re-enter password:
	Please type your full legal name, or the full name of the principal investigator. (Required.) [Privacy Policy]
Last name:
First name:
Middle initial (optional):
Academic credentials, certifications and licensure (E.g. M.A., Ph.D., LPC, NCC etc.) Optional but strongly encouraged:
E-mail address: [Privacy Policy]
Please re-enter your e-mail:
	Please indicate your professional status:
	Graduate student in a counselor preparation program
	College or university professor/lecturer in a graduate program that prepares professional counselors (i.e., "Counselor Educator")
	State-credentialed professional (e.g., LPC, LMFT, LCSW, certified school counselor)
	Practitioner exempt from state licensure
	Consultant or curricular specialist
Other role:
	Please describe your practice specialization:
	K-12 school counseling
	Postsecondary advisement, student personnel or related
	Mental health counseling
	Counseling or Clinical Psychology
	Social Work (any setting)
	Marriage and family therapy
	Rehabilitative, addictions or offender counseling
Other specialty not listed above, or pertinent ACA division if a member:
	Where are you? (Required.)
What is the name of the practice/agency/school where you work or study?
Location: (city/state or country)
	Pick the statement that best describes you:
	My primary professional identity or program of graduate study involves a Counseling or related field, as described accurately above. (Establishes elibigility to use the free survey distribution service.)
	I am not a Counseling professional, but would like to create an for the following reason: (Please describe your interest in the site)
Reason:	(Please describe.)
	Please check your agreement with the following terms of service:
I agree	I certify that all information I have provided is accurate. I will adhere to the ACA Code of Ethics when using this web site for research purposes and when communicating with the public. If I am distributing surveys in a public school setting, I will adhere to the ASCA Code of Ethics and observe all applicable local, state and federal laws governing distribution of surveys to minors. I acknowledge responsibility for my proficient use of this site, and agree to notify the administrator of any technical problems encountered. Please note: New accounts will become activated upon response to confirmation e-mail, and will be reviewed by the website administrator the next business day. Please check your name and work setting information before submitting form; thank you.