Join Our Practitioner Affiliate Program

Name (required)

Business Name

Job Title

Mobile Number (required)

Practice Name (if applicable)

Qualifications (e.g. naturopath, nutritionist etc) (required)

Location (including suburb) (required)

Area of Speciality (e.g. fertility, kids health, digestion etc) (required)

Do you offer both in person and tele-health appointments? (required)

Website URL, booking link or email address (this is how patients/clients will contact you)

Average number of Clients per week:

Create Username (required)

Password (minimum 8 characters) (required)

Confirm Password (required)

Email Address (required)

Paypal Payment email (if different from above – commissions will be sent here) (required)

Please tick if you wish to have your bio appear on our Natural Health Practitioner listing page

Please tick if you are a member of the Well Nourished Family

Please tick if you’re registered for GST

I have read and agree to terms & conditions