Physio Registration

Create an Account

First Name*
Last Name**
Username*You can use this to log into your account. This would most likely be your physiotherapy clinic name.
Password*You'll need this to log into account to manage your bookings on the day.
Physiotherapy Clinic Name*
Email Address**
Clinic Street Address*This will be displayed for clients to find you on the day
Town/City*
County*
Eircode**
Short Description*Tell people about your clinic - what do you specialise in, where are you located?
Clinic LogoThis should be a square image on a white background if possible. You can upload your logo in a number of different file formats - .jpg, .png or .jpeg
Accepted file types: jpg, png, jpeg.
Consent*
I agree to the handling and processing of my data.*

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