Submit Your Practitioner Profile

Your Details

Name

Email

Phone

Date of birth

Date of Birth

Address

Street Address

City/Suburb

Postcode

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Worked Related

ABN

Insurance Expiry Date

Insurance Certificate of Currency

YesNo

Qualifications – Massage, (Remedial,/Cert IV) , Yoga Teacher, Other provider of wellness/fitness?

QualificationsMassage, (Remedial,/Cert IV) , Yoga Teacher, Other provider of wellness/fitness?

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Are you a registered Health Fund Provider?

YesNoApplication in progress

Association Membership

Do you have your own massage chair/ Yoga equipment/ equipment related to your services?

YesNo

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Previous Experience

Corporate Massage/ Yoga /Wellness/Fitness experience?

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Other Corporate Massage/ Yoga /Wellness/Fitness Companies you have worked for, current and past

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Companies you have provided Corporate Massage/ Yoga for

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Extra Information

Other qualifications please specify

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Preferred shirt size? ( All practitioners must wear our polo shirts)

If referred to us, who referred you?

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Practitioner Profile