TherapyWorld - Therapist Join Now

Therapists - Join TherapyWorld

Please enter your information on this form, and you will receive log in information via email and instructions on how to fully utilize this site. REQUIRED Information is Marked *
First Name: *
Last Name: *
Title:
Practice Name:
Email Address: *
Main Phone: *
Main Fax:
Primary Location
Main Address:
Main City St Zip:
Country:
Payment Information
Name on Card: *
Card Number: *
Expiration: *
CVV2: *
Billing Address:
City St Zip:
Category(s): *	Mind Body Spirit
TERMS A. I authorize TherapyWorld to charge my credit card for $120 for an annual membership to the TherapyWorld website. If I have provided the name of a Professional Organization and my associated member ID, I understand that I will receive a 40% discount on that annual membership ($48 savings.) B. The initial term of this Agreement will commence the day the online application is submitted via the Internet, (within a commercially reasonable time after payment is received) and will continue for a period of one (1) year. Thereafter this Agreement will automatically renew for successive one (1) year periods unless either party gives the other party not fewer than thirty (30) days notice of its intent not to renew, or unless terminated earlier under the terms contained within this Agreement. C. Either party may terminate this agreement provided, however, that the terminating party has given the other party at least Thirty days (30) written notice (written notice can include an email to cancellationnotice@TherapyWorld.com.). Accept
If you are a Member of a Professional Organization you can receive a 40% discount on your annual membership.
Name of Organization:
Member ID Number:
I hereby Authorize TherapyWorld to charge my credit card for an annual membership to TherapyWorld.com.