Register | The Vital Compass

Practitioner Registration

First Name *

Last Name *

Email Address *

Password *

Confirm Password

Clinic Name

Web Address

Mobile (numbers only eg: 3337779999)

Phone (numbers only eg: 3337779999)

License number/School ID number (students, send a photo of your school ID to info@thevitalcompass.com) *

State of Licensure/School *

Practitioner Type *

Address 1

Address 2

Country

State

City

Zip Code

License upload

(file should be less than 50mb) (Format: docx./pdf/png/jpeg/jpg)

License Expiry Date

Agree to Terms and Conditions