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 Other option
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 *

FMT Certifications

For medical professionals, please include your RockTape Certification details.
Have you completed an FMT or PMT 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 Performance FMT Blades FMT Special Populations FMT Movabilitty FMT Equine FMT Canine Other option
If yes, what FMT courses have you completed?

FMT Basic FMT Performance FMT Blades FMT Special Populations FMT Movabilitty FMT Equine FMT Canine
AMP Program

Earn more money and drive new patients to your practice or clinic.
Do you participate in RockTape's AMP Program?

Yes No No, but I'd like to
Want to learn how AMP can help your business? Click here to learn about AMP.
Should be Empty:

Get Listed on our Locator