FAON Application

Family Advocacy Outreach Network (FAON) Membership Application
We are so excited and honored that you're considering joining FAON! Your expertise and services will be critical in providing much needed help to people in your community.

FAON members are referred cases by NCMEC involving an individual who was missing or exploited as a child, as well as their non-offending caregivers. These cases involve children who have been abducted, gone missing voluntarily, experienced online sexual exploitation, sextortion, molestation, sex trafficking, and many other crimes.

There are a few requirements and great benefits to being an FAON member.
Click here to learn more: https://www.missingkids.org/support#faon

Email FAON@NCMEC.org if you encounter problems or have any questions.

There is an option to save and continue your progress later at the end of this form.
Applicant Information
Applicant Name*

First NameLast Name
Organization Name*
Website*
Job Title
Applicant Phone Number*
Please enter a valid phone number.
Applicant Email Address*
example@example.com
Professional License
I am interested in joining FAON as a...*

Licensed clinician. (Select this option if you are applying yourself, and not your organization, as an FAON Member. Your FAON status goes with you regardless of which place you work).Services organization. (Select this option if you are applying your organization, and not yourself, as an FAON Member. Your FAON status stays with the organization, and not you, should you leave the organization listed on this application).Pre-licensed clinician. (Select this option if you plan to get your license soon. If you do not plan to get a license, please select Services Organization above).
Professional's Name:   First Name*   Last Name*
License Number:   *
Type of License (LMFT, LCSW, LPC, etc.):   *
Licensing State:   *
License Expiration Date:   Type a label*
Please provide your license information. If you are un-licensed, please list the license information of a provider(s) in your organization (such as a clinical director).

Professional's Name:   First Name*   Last Name*
License Number:   *
Type of License (LMFT, LCSW, LPC, etc.):   *
Licensing State:   *
License Expiration Date:   Type a label*
Please provide the following information about your supervisor.

Professional's Name:   First Name*   Last Name*
License Number:   *
Type of License (LMFT, LCSW, LPC, etc.):   *
Licensing State:   *
License Expiration Date:   Type a label*
Do you want to add an additional license (Up to 3)?

YesNo
Professional's Name:   First Name   Last Name
License Number:
Type of License (LMFT, LCSW, LPC, etc.):
Licensing State:
License Expiration Date:   Type a label
Professional's Name:   First Name   Last Name
License Number:
Type of License (LMFT, LCSW, LPC, etc.):
Licensing State:
License Expiration Date:   Type a label
Professional's Name:   First Name   Last Name
License Number:
Type of License (LMFT, LCSW, LPC, etc.):
Licensing State:
License Expiration Date:   Type a label
If you have more licenses to list, please provide that information here:
Other Organization Staff Members

If applicable, please enter the names and contact information for any staff members that can provide clinical services to NCMEC cases. This will help us have a better understanding of services provided and who to contact directly for specific needs. You may add up to 10 additional staff members.
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Staff Member's Name:   First Name   Last Name
Title/Role:
E-mail:   Email
Direct Number:   Area Code   Phone Number
Has there ever been disciplinary action against you, the agency or any of the professionals in the group (including, but not limited to, reprimand, suspension or revocation of license)?*

YesNo
Please provide detailed information for each incident:
Service Details
I can clinically support those impacted by:*

Child Sexual Abuse Materials (CSAM)Child Sex TraffickingOnline Sexual Exploitation (Financial Sextortion, Sadistic Online Exploitation, Generative Artificial Intelligence CSAM)Family AbductionNon-Family AbductionVoluntary Missing/Runaway YouthOther
If you offer services in any languages other than English, please list them:
How do you provide services?*

In-PersonVirtualOther
What is the address of your in-person location?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you want to add another in-person location (Up to 3)?

YesNo
What is the address of your in-person location?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is the address of your in-person location?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is the address of your in-person location?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If you have more in-person locations to list, please provide that information here:
What US states/territories do you provide virtual services in?*
What is your mailing address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Treatment Modalities:*

Art TherapyAnimal Assisted TherapyCBTTF-CBTDBTEMDRFamily Systems TherapyMarriage and Family TherapyPlay TherapyOther
What ages do you work with?*
What is your self-pay rate for individual counseling?*
FAON membership requires clinicians and agencies to provide a sliding scale/pro-bono rate to NCMEC referred clients. What is your sliding scale rate and how is it determined?*
Do you offer pro-bono services and what are the requirements?*
Which insurances are you in-network with?*
Please list any additional payment methods you accept:
Do you have professional liability insurance?*

YesNo
Which days and times do you provide counseling services?*
Do you currently, or often, have a waitlist for counseling services?*

YesNo
What is your current or typical waitlist?
Is there anything else that you would like us to know about yourself or your practice/organization that this application did not address?
This may be certain populations, cultural competencies, or other specializations or services you offer, that you would like us to know about.
How did you hear about FAON?*

FAD Specialist contacted me for a referralOnline (Google, social media, LinkedIn)ConferenceColleagueOther NCMEC EmployeeOther
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Family Advocacy Outreach Network (FAON) Membership Application

Applicant Information

Professional License

Other Organization Staff Members

Service Details