Become a Wellness Partner

Full name *

Email address * Where we send your promo code once you are approved.

Phone number

Business or practice name

City *

State *

Professional category *

Select the category that best describes your professional background. This helps us verify your credentials and match you with the right members.

Are you a licensed or certified professional? *

I am a licensed professional e.g. physician, dietitian, physical therapist, mental health professional I am a certified wellness professional e.g. health coach, nutrition coach, yoga instructor, fitness instructor

License / Credential Details

License or credential type *

License or credential number *

Issuing state or governing organization *

Expiration date

Upload proof of credential * JPG, PNG or PDF, up to 10 MB. Only the Swolemance team sees this — it is never shown on your listing.

Listing title Shown on your card. Leave blank to use your profession.

Years of experience

Areas of specialty * (select all that apply)

About you * 0/500

Website

Instagram

Profile photo *

A clear head-and-shoulders shot. JPG or PNG, up to 5 MB.

To maintain a safe and trusted community, Swolemance may verify the supplied credentials with the appropriate state board or certifying organization before publishing your listing. Submission of this form does not guarantee approval.

Good standing attestation. I confirm that my license(s) or credential(s) are current, active and in good standing, and have not been suspended, revoked or subjected to disciplinary action. *

Additional information (optional)

Agreements

I agree to the Swolemance Terms of Service * I agree to the Swolemance Privacy Policy, and I am happy for the details I have given to appear on my public listing. *

Become a Swolemance Wellness Partner

License / Credential Details

Thanks — we have your details