List Your Practice (free) (Required fields are in bold with *)
• Optional fields left blank will not show on your profile.
• If you're going to spend more than 30 minutes on this form, fill out the required fields* first, save, then revise your profile later.
Your Professional Title:*
Your Email*:
 Will not be shown on your profile. Our system will forward messages to this address.
Retype Email:*
Create Password:*  (at least 5 chars)
First Name:*
Last Name:*
Designations:  E.g. LMT. (Don't repeat your name here)  chars left
Practice Name:   chars left
Leave this blank if you don't use a practice name. Don't repeat your own name here.
Headline 1:*   chars left.
The shorter your headlines the bigger their font will be. Edit your profile later and experiment.
Headline 2:   chars left.
Profile Display:*
Clients Can Contact Me By:*
Profile URL:* massagenext.com/profile/   chars left
Choose your personalized profile page URL here. Keep it meaningful and simple (i.e. /YourName).
Must contain only alphanumeric characters (a-z and/or 0-9) and "_" or "-" instead of spaces.
Example: If you enter JohnSmith your profile URL will be: massagenext.com/profile/JohnSmith
Address 1:  If you are a mobile practice, leave this blank.
Address 2:
Zip/Postal Code:*  Only use 5 chars for U.S. zip codes
Phone:*  Will not show on your profile if you choose "Clients can Contact Me by Email Only" above.
Click to add a 2nd address  
Alt. Address 1:
Alt. Address 2:
Alt. City:
Alt. State/Country:
Alt. Zip/Postal Code:  Only use 5 chars for U.S. zip codes
Alt. Phone:
Website:  E.g. www.mysite.com
Payments Accepted:
 chars left

E.g. cash, check, type of insurance, credit cards.
License Info:
(300 chars min)
 chars left
Important! Enter at least 2000 characters above to get optimal results from your profile. Robust profiles get more results and get found in Google more often.
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Other Languages:
Your Practice Areas:*

IMPORTANT: Make sure to select all possible practice areas above to make sure people can find you.
Your Certifications:*

Helpful links for potential clients
• All links must have descriptions.
Link #1:   chars left
E.g. http://feelbetter.com
Link #1 Description:   chars left
E.g. Daily routines that can improve your health and wellness
Link #2:   chars left
Link #2 Description:   chars left
Link #3:   chars left
Link #3 Description:   chars left
Link #4:   chars left
Link #4 Description:   chars left
Link #5:   chars left
Link #5 Description:   chars left
Allow Recommendations: If checked, your profile can display recommendations and testimonials. You approve all recommendations before they display on your profile and you can easily delete any recommendations.
Terms:* I agree to the Professional User Agreement and Terms of Service
Name of this fruit:* captcha  (to show you're human)