To Register as a Practitioner

Benefits of Registering as a Practitioner include:

1. Access to all Technical Information for Practitioners
2. Receive regular updates on technical information
3. Access Technical Sheets and Newsletters
4. Access the On-Line Practitioner Educational Program
5. Access to ordering products on-line with special and wholesale Practitioner prices

To apply for a username and password to view the Practitioner's section and shop online at a discount, please complete the form below:

Title:
First name: *
Surname: *
Clinic name:
Mailing address: *
Suburb/city: *
State: *
Postcode: *
Country: *
Phone: *
Mobile:
Fax:
Email: *
Practitioner's modality: *	select ... acupuncturist chiropractor dentist health food store herbalist homeopath kinesiologist massage therapist medical doctor naturopath nutritionist osteopath pharmacist physiotherapist psychologist registered nurse trichologist veterinarian other student
Professional association: *
Provider/member number: *
Student:
Course:
College:
Student number:
Year of study:
Do you wish to be sent newsletters by:	Post Email
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* denotes required fields