Practitioner - Register

Practitioner Registration

Please enter your personal information and proceed to next step

First name *

Last Name *

Gender Male Female

Medical license number *

Email address *

Telephone (optional)

Mobile number *

Please enter your practice information to complete the registration process

Practitioner Type *

Job Title *

Password *

Show

Confirm Password *

Show

Languages Spoken * (should select atleast one)

Refund Percentage

You can change the refund percentage once you are linked with a clinic.

About me *

I agree ShopDoc Website terms & conditions and Data privacy policy