Treatment Application

You may download an application directly from our website. Two formats are available - .doc and .pdf. Both applications can be typed in. If you wish to hand write your application, use the .pdf file.

• Application - Microsoft Word .doc file
• Application - Adobe Acrobat .pdf file *

*You must have Adobe Acrobat Reader in order to view and/or print this file. Acrobat Reader can be downloaded (at no cost) from Adobe’s website at www.adobe.com.

Treatment Application Fee

Pay Online

You may pay your $50 application fee online through paypal or with your credit card (no need for a paypal account). Click on the "Pay Now" button below.

Pay by Check or Money Order

You may also pay us by making a check or money order out to the Institute for Psychoanalytic Education

Mail to:
Institute for Psychoanalytic Education
Affiliated with NYU School of Medicine
462 First Avenue OBV-CD 230
New York, NY 10016