Resource Submission Please select from the below drop-down box. Note: If you are clinician and wish to be listed on our resource listing, please select the category of “Mental Health Professionals” before filling out the supplied on-line form. Thank you. Resource Type*Mental Health ProfessionalAgency: Adoption/Foster CareCampsSupport GroupsMedical ServicesOther ServicesResource Name (Group / Camp / Organization)* How did you hear about us?Name of Mental Health ProfessionalCredentialsAddress 1Address 2CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip CodeContact NameTitleHotlinePhoneExtensionSecond PhoneFaxEmail Second Email Website Region* Atlantic Bergen Burlington Camden Cape May Cumberland DE (State) Essex Gloucester Hudson Hunterdon Mercer Middlesex Monmouth Morris NY (State) Ocean Other (State) PA (State) Passaic Salem Somerset Sussex Union Warren Type* Adoption Agencies Camps (Adoption Focused and / or Special Needs) Children's Crisis Intervention Services Family Service Association of New Jersey Family Support Organizations Fetal Alcohol Syndrome Diagnostic Centers Home Heritage Tours Legal Services Medical Services Mental Health Professionals Mobile Response and Stabilization Services Neighboring State Resources Other Services Pre and Post Adoption Counseling Services Support Groups Resource TopicsSeparate multiple topics by comma (Teens, Teenagers, Counseling)Type of Support GroupType of CampServices ProvidedPopulation ServedActivities Age Range of ClientsSpecialitiesProfessional / Personal Experience with Adoption Do you accept Medicaid?YesNoDo you accept any other insurance?(Please specify insurances you accept.)Do you accept private clients?YesNoEducation / Training in AdoptionOther Information Terms of Submission* Submittor Consent I, hereby authorize the New Jersey Adoption Resource Clearing House (NJ ARCH) Directory to include information about our organization/agency on its Website and in print documents. We agree to provide information to NJ ARCH and to periodically update the information provided. We understand that we may request that our organization’s name and information be withdrawn from the Directory, at any time by contacting NJ ARCH. We understand that inclusion in the NJ ARCH Directory is not an endorsement of our services by NJ ARCH, Children’s Aid and Family Services Inc., or the Division of Child Protection and Permanency. We certify that the information provided to NJ ARCH is accurate to the best of our knowledge.NameThis field is for validation purposes and should be left unchanged.