Become a RockTape Medical Professional

Get Listed on our Locator

We need some details about your location. Have questions? Email us at student@rocktape.com.
Your Name

First NameLast Name
Your Email
Phone Number

Area CodePhone Number
Your State
Purchasing Information

You must make regular purchases of RockTape to be listed on our locator ($150 worth of retail items within the past six months, excludes education).
I purchase from

Other
Location Information

We use this information to list you on our locators. Please ensure it's accurate.
Location Type
Clinic Name
This can be a name (e.g. Sports Chiropractic of Denver) or your name.
Clinic Phone

Area CodePhone Number
Clinic E-Mail
Clinic Website
Clinic Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
FMT Certifications

For medical professionals, please include your RockTape Certification details. You must take a course with us in order to be listed on our locator.
Have you completed an FMT Certification?
If yes, what FMT Course did you attend?
Include class location & date, if possible.
If yes, what FMT Courses did you attend?

Other
If yes, what FMT courses have you completed?

Other
Should be Empty:

Get Listed on our Locator