BECOME PRACTITIONER

Applicant Information

What information do you want customers to see on the geneway website?

Second Practice address if applicable

Education & occupation

YOUR REQUIREMENTS & INTERESTS

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. I understand that it is at the sole discretion of GENEWAY TM to accept my application, or revoke my status as a GENEWAY TM Practitioner.