Premium Special Needs Directory Please complete the form below to create your premium directory listing. Once you submit your information, you will be transferred to a secure form to make your one-time payment of $250. All listings are active for 12 months. Name of Business or Service: Titles using all caps not accepted Business or Service Description:1,500 character max. | 1500 characters left Upload Main Image or Logo: Max. width 600 pixels at 72dpi - 300x250 preferred. Primary Business Address: Will display as text in listing Location Address for Google Maps: Tip: Exclude suite or building numbers. Example: 4611 S. University Dr. Davie, FL 33328 Primary Business Phone: Secondary Business Phone: Contact Email: Website Address: Business Hours of Operation: Ages Served: List Services Provided: Insurance Accepted: In Business Since?: Non-profit Agency?: Yes No Not Applicable Doctor Referral Required?: Yes No Not Applicable Disabilities Served: Categories: Select the categories you want your listing associated with in search results - limit of 3 ADHD Autism Bereavement Support Diagnostic Centers Early Intervention Eating Disorders Family Support Finding Friends Hearing & Vision Mental Health Respite Care Special Education Speech Support Organizations Therapy Centers Transitioning to Adulthood -- Parent -- Add New Extra Images: Add up to 8 additional images. Upload Extra Image 1: Max. file size = 1MB. Upload Extra Image 2: Max. file size = 1MB. Upload Extra Image 3: Max. file size = 1MB. Upload Extra Image 4: Max. file size = 1MB. Upload Extra Image 5: Max. file size = 1MB. Upload Extra Image 6: Max. file size = 1MB. Upload Extra Image 7: Max. file size = 1MB. Upload Extra Image 8: Max. file size = 1MB. Add Video 1: Add a YouTube or Vimeo video. Add Video 2: Add a YouTube or Vimeo video. Company Contact Name: (In case we have any questions - Required) Email Address: Contact Phone: Please validate reCAPTCHA CONTESTS & PROMOTIONS - Advertisement -