Register

Register with Physio Roots

You must register prior to claiming or adding a clinic.

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 will be used to activate your account and can be different than the clinic email.
Clinic name*
Username (used for logging into your account)*
Password*
Enter Password Confirm Password

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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)
Email updates include important updates to website terms of use and privacy policy, as well as updates to new website features.
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