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Simply complete the form below to join Private Practice Hub and immediately start enjoying the benefits of membership!

	Bronze	Silver	Gold
Cost	£5.00 per month £50.00 per year	£10.00 per month £110.00 per year	£19.50 per month £195.00 per year
	Selected	Select	Select

Username

Password

Confirm Password

First Name

Last Name

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

What type of therapist are you?

Please select applicable sub-categories

Which association(s) do you belong to, if any?

What is your registration number?

Do you deliver online therapy at the moment?

Yes

Are you considering delivering online therapy in the future?

Yes

£5.00 per Month.

£50.00 per Year.

Card Type

Card Number

Expiration Date /

CVV (what's this?)

Discount Code

I agree to the Terms & Conditions.

I hold relevant professional liability insurance for my practice

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