Register

Register Your Clinic!

This form is simply to register an account with Physio Roots. After your account is registered, you can then claim or add your clinic.

You'll be redirected to setup your clinic immediately after registering.

Clinic name*
Account holder name*
First Last
Clinic Address*
Street Address Address Line 2 City Province Postal Code
Clinic phone*
Alternative phone (ie. account holder phone)
Email*
Enter Email Confirm Email

This can be different than the clinic email. This email is used for communication between Physio Roots and the account holder.
Username (used for logging into your account)*
Password*
Enter Password Confirm Password

Strength indicator
Privacy Policy*
I have read and agree to the website privacy policy.
Terms of Service*
I read and agree to the website terms of service.
I consent to receive email updates (recommended)
Sign me up!
Physio Roots is constantly changing. Updates could be about anything from new skills and services that you can add to your clinic, to brand new account features. Email updates may also include terms of use and privacy policy updates. These updates are infrequent and you can opt out at any time.
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