Completing the Renewal Application Form
- You must complete all sections of the application. If a question does not apply to you, mark it "N/A."
- Please do not leave any question or section blank. If your application is incomplete, it will be sent back to you for correction; a delay that may result in a late renewal fee. (See Due Dates & Fees information below)
Forms Required to Complete Renewal
To complete your renewal application the following forms will need to be uploaded. Please be sure to separate and scan/upload the forms according to the category as listed below:
- Current license (or registration for NY) for each therapist. Please send the document that is renewed every few years, not the original license.
- Copy of the facility's general liability policy
- Copy of practice's malpractice policy
- Facility information update
- Insurances accepted
- Services and conditions treated
Tips for a Smooth and Successful Renewal Submission
- Complete the form on Google Chrome.
- Have the most updated version of Adobe Reader on the computer you are working off of.
- All documents should be scanned in PDF(.pdf) format on the computer you will use to complete your renewal.
- HINT-To save time, separate and group documents according to category and upload the group in the appropriate location. ex: All therapist licenses in one .pdf, all insurance documents in one .pdf
Step One: Accessing the Form
- To renew your membership click the appropriate link below.
- To have access to one of the below links you must have the appropriate credentials/ "Member Type". These "Member Type" credentials reflect your form of payment from last year.
- IMPORTANT: If you would like to change your form of payment, please contact us to change your status BEFORE you start your renewal.
- To get your username: Username
- To get your password: Password
- Your username and password were also sent in a separate email. You can change your password after initial login if desired.
- To complete the form and pay with a CHECK: Company Renewal - Check Only
- To complete the form and pay with a CREDIT CARD: Company Renewal - Credit Card Only
*** An $89 CC processing fee is added to this method of renewal.
***Note: Each Network location is assigned its own identity in our system. If you have multiple practices in the network be sure to LOG OUT of the system before starting the renewal for the additional locations. Failure to do so will overwrite the original submission for the previous entry.
Step Two: Practice Information
- The first page will auto-populate information from your last renewal (some information will likely be outdated).
- It is imperative that you read all content thoroughly and make any/all appropriate corrections.
Step Three: Current Therapists
- You will be prompted to “Create Linked Profiles” This is where you will add all your treating therapist information.
- You can add as many current therapy employees and update their license information (a copy of their current license (or registration if NY) must be uploaded). Please include all owners in this section.
Step Four: Invoice and Payment Plan
You will be invoiced for the total amount of your membership fee after you complete your renewal form. We are offering a 2-part payment plan. Payments are due by the stated deadlines. If you would like to participate in the payment plan program, please follow the instructions below:
Paying via Credit Card
- Select the renewal link that says Company Renewal - Credit Card Only
- AFTER you complete the form, select "invoice me" and contact our office to provide CC information details.
- We do not keep the credit card number on file; therefore, you will need to contact our office to submit the second payment.
Paying via Check
- Select the renewal link that says Company Renewal - Check Only
- Once you complete the form, select "invoice me" and send the first payment.
IMPORTANT: If you would like to change your payment method from last year, please contact us to change your status BEFORE you start your renewal.
Payment Options
- In response to member requests, we are pleased to offer a credit card payment option for your renewal.
- Credit card payments will be processed by an outside vendor and include an eighty-nine-dollar ($89) service charge. If you choose the credit card payment option, the service charge will automatically be added to your invoice.
- Of course, you always have the option to pay by check without an additional service charge.
- Payment in full is required at the time of renewal, so those who prefer or need to pay their membership off over time should content the Network office to make arrangements.
- Late payments, regardless of payment method, are subject to a $150 late fee.
If you have any questions or difficulty with the renewal process, please contact the Network office at 212.606.1317.