This website uses cookies to store information on your computer. Some of these cookies are used for visitor analysis, others are essential to making our site function properly and improve the user experience. By using this site, you consent to the placement of these cookies. Click Accept to consent and dismiss this message or Deny to leave this website. Read our Privacy Statement for more.
Print Page | Contact Us | Sign In | Join APT
Approved Provider Required Program Reviewer
Share |

Required Program Reviewer Update Form

In accordance with the Approved Provider Criteria and Standards, Approved Providers must notify APT when a change occurs in their Required Program Reviewer.

Please use the form below to submit the name, credentials and contact information for the Registered Play Therapist (RPT) or Registered Play Therapist-Supervisor (RPT-S) who will be the new designated Program Reviewer for your Approved Provider Status. Note that you will be asked to upload a completed Required Program Reviewer Attestation Form and should have this completed prior to attempting to submit this form.

For questions concerning the Approved Provider Program, contact Alexandra Jarrell, Continuing Education & Credentialing Coordinator, ajarrell@a4pt.org, or 559-298-3400 x4.

I have read the Privacy Policy and grant consent to use my data.
New Program Reviewer must complete this attestation.