Wellness Provider Network

Apply to the founding cohort.

Apply to join KemetiCare's Wellness Provider Network of independent wellness professionals. Practitioners are introduced to members only after credential and licensure verification is complete.

Practitioner application

First name*

Last name*

Email*

Phone

Primary discipline*

Credentials*

As they should appear on your listing, e.g. RDN, NBC-HWC, LCSW.

License number and issuing jurisdiction

If your discipline is licensed. Leave blank if it is not.

Practice website

How would you describe your practice to a member?

Describe your services and approach only — no client or patient details.

I attest that the information above is accurate and that I am an independent professional, not employed by KemetiCare.

I agree that KemetiCare may contact me about this application.

Please do not include symptoms, diagnoses, medications or other health details in any field. KemetiCare does not collect health information through this website.

By applying you attest that the credentials and licensure you provide are current, accurate and verifiable, and that you practice as an independent professional and not as an employee or agent of KemetiCare.