Include Your Practice In The Lyme-literate Physician Directory

Personal Information

First Name*

Last Name*

Type of provider (e.g. MD, DO etc)*

Internal Email*

Enter Email Confirm Email

This email will be used for internal use only and will not be accessible / viewable to the public.

Patient Accessible Email

Enter Email Confirm Email

This email address will be public facing and patient accessible. Only enter if you would like your listing to include your email address.

Website

Facility Name*

Address*

City*

US State*

Province or Region

Zip/Postal Code*

Country*

Phone*

Contact Person

Practice Specialty*

Other Type of Practice Specialty

Do you want to be part of waiting room program?*

Learn more about the Waiting Room Program.

Does your practice accept insurance?*

Does your practice accept medicare?*

Are you a member of the International Lyme and Associated Diseases Society?*

How many CME training classes have you taken in Lyme disease and other tick-borne diseases?*

None
I have been trained by another Lyme literate clinician
I have attended one or more ILADS conferences
I have attended one or more LDA/Columbia conferences
I have taken an online CME course through Partnership for Healing and Health (Dr. Elizabeth Maloney

(Check all that apply)

Do you follow any guidelines for the treatment of Lyme disease?*

I follow the guidelines of the International Lyme and Associated Diseases Society
I follow the guidelines of the Infectious Diseases Society of America
I follow the guidelines of Dr. Joseph Burrascano
I don’t follow any particular guidelines

(Check all that apply)

What type of treatment do you provide for Lyme disease and other tick-borne diseases?*