Become a RockTape Medical Professional

Get Listed on our Locator

We need some details about your location. Have questions? Call us at (408) 912-ROCK.
Your Name *

First Name Last Name
Your Email *
Phone Number *

Area Code Phone Number
Your State *
Purchasing Information

You must make regular purchases of RockTape to be listed on our locator.
I purchase from

RockTape Meyer Patterson Scripp Theratape
Location Information

We use this information to list you on our locators. Please ensure it's accurate.
Location Type *

Medical Retail Option 3
Clinic Name *
This can be a name (e.g. Sports Chiropractic of Denver) or your name.
Clinic Phone *

Area Code Phone Number
Clinic E-Mail *
Clinic Website *
Clinic Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
FMT Certifications

For medical professionals, please include your RockTape Certification details.
Have you completed an FMT Certification? *

Yes No No, but I plan to
If yes, what FMT Course did you attend?
Include class location & date, if possible.
If yes, what FMT Courses did you attend? *

FMT Basic FMT Advanced FMT Blades FMT Blades Advanced FMT Rockpods FMT Rockfloss FMT Movement Specialist FMT Movement Specialist Advanced FMT Mobility Specialist FMT Pediatrics FMT Geriatrics FMT Performance Specialist
If yes, what FMT courses have you completed?

FMT Basic FMT Performance FMT Blades FMT Blades Advanced FMT Rockpods FMT Rockfloss FMT Movement Specialist FMT Movement Specialist Advanced FMT Mobility Specialist FMT Pediatrics FMT Geriatrics FMT Performance Specialist
Should be Empty:

Get Listed on our Locator

Purchasing Information

Location Information

FMT Certifications