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 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

RockTapeMeyerPattersonScrippTheratape
Location Information

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

MedicalRetailOption 3
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?*

YesNoNo, 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 BasicFMT AdvancedFMT BladesFMT Blades AdvancedFMT RockPodsFMT RockFlossFMT Movement SpecialistFMT Movement Specialist AdvancedFMT Mobility SpecialistFMT PediatricsFMT GeriatricsFMT Performance SpecialistFMT Industrial Athlete
If yes, what FMT courses have you completed?

FMT BasicFMT AdvancedFMT BladesFMT Blades AdvancedFMT RockPodsFMT RockFlossFMT Movement SpecialistFMT Movement Specialist AdvancedFMT Mobility SpecialistFMT PediatricsFMT GeriatricsFMT Performance SpecialistFMT Industrial Athlete
Should be Empty:

Get Listed on our Locator

Purchasing Information

Location Information

FMT Certifications