New Account Registration
Consumers: Simply select your items in your cart and choose "New Customer Checkout".
Practitioners: FAX a copy of your state license to 949-587-1260, or email a copy to email@example.com. For states with no licensure, FAX or email a copy of NCCAOM and graduation diploma.
Students: FAX a copy of your Acupuncture School's Student ID to 949-587-1260, or email a copy to firstname.lastname@example.org.
Practitioner Registration Only
Please fill out this form completely to submit your application. Required fields are marked with an “*"