(012) 346 2469 info@geneway.co.za

Book Online Feedback Session

HOME
SHOP
HOW IT WORKS
- HOW DOES THE TEST WORK
- FAQ
TESTS
SUPPLEMENTS
LEARN MORE
FIND A PRACTITIONER
BECOME A PRACTITIONER
CONTACT US
LOGIN/REGISTER
Book Collection

Select Page

BECOME A PRACTITIONER

Complete the below application or download the application form by clicking HERE.

Become a practitioner Form

Comments

This field is for validation purposes and should be left unchanged.

Applicant Information

Title(Required)

(Required)

First Last

Gender(Required)

Date of Birth(Required)

Email(Required)

Phone

Physical Address Line

City(Required)

Province(Required)

Code(Required)

Country(Required)

Social Media Links

EDUCATION & OCCUPATION

Please confirm your medical healthcare occupation(Required)

Untitled

Are you registered with a medical profession board?(Required)

Yes

No

Enter registration number eg (DT0918686 , P6885)

QUALIFICATIONS

Are you VAT registered?(Required)

Yes

No

Please enter your VAT number(Required)

Hobbies/Interests

In which areas of genetics or preventative medicine are you interested?(Required)

Weight loss & Diet

Health & Wellness

Anti-ageing / Skin

Sport

Fertility

Medications & Pharmacology

DISCLAIMER AND SIGNATURE

You agree to Geneway's Terms & Conditions and Privacy Policy.

POPI: I hereby consent to the personal information provided by me to be used for marketing purposes by GENEWAY. I am aware that I can unsubscribe to any newsletters, campaigns, communications from GENEWAY by notifying them accordingly. It is my right to request GENEWAY to delete and cease to use any of my personal information. Should I believe that there has been a misuse of my personal information, I am aware that I can lodge a complaint with the Information Regulator at inforeg@justice.gov.za(Required)

I Agree(Required)

Scan below to be added to the Geneway Whatsapp Practitioner Group

Geneway_Whatsapp_Group_QR-1024 (1)

Quick Links

HOME
SUPPLEMENTS
FIND A PRACTITIONER
TESTS

LIFE360 ACADEMY

PRACTITIONER PORTAL

Contact Details

Physical Address:

Alenti Office Park
Building B
457 Witherite Street
The Willows, Pretoria
0040

Contact Number: 012 346 2469
Email Address: info@geneway.co.za

Legal Documents

Privacy Policy
Terms & Conditions
Legal Disclaimer

Facebook
Instagram

We are using cookies to give you the best experience on our website.

For more information read our Terms & Conditions.

Thanks for your enquiry.

Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

Enable or Disable Cookies Enabled Disabled