Worldwide Physiotherapy Clinic Database
The items with an asterisk need to be filled out or it won't let you submit. Please fill out as much information as you can.
***Please Read This First*** This database of clinics is only for physiotherapy clinics outside of the United States. If you have a clinic in the US, please use that form instead.
Clinic name *
If you have multiple clinics with the same name, only put the clinic name here. The address location will put the clinics where they need to go on the map. Example: don't put "Clinic Name - City" unless that is the registered business name.
Your answer
The next questions are regarding the physical address.
Street Address *
Example: 555 Main Street
Your answer
City *
Your answer
Province
State, province, or territory. Please do not abbreviate, spell it out.
Your answer
Country *
Please spell it out, do not abbreviate.
Your answer
Phone number
Phone number for scheduling appointments
Your answer
Email address
Email address for scheduling appointments
Your answer
Clinic website
Enter in the format www.example.com
Your answer
We hope to have this new map up by the end of 2017, so please be patient while we gather this data and go through the process of redesigning the website.
This basic map will be free, but if you'd like to make a tax deductible donation to our favorite charity, click this link - https://www.paypal.me/STANDhaiti/10
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