Renewing Member Form
Complete this form to verify or update your Healing Arts Alliance member information.
You must login to your Google Account to complete this form (as a method for us to ensure accuracy).
Email address *
Verify Your Member Info
Please provide your personal information below so we can make sure we have the most up-to-date contact info for you.
Your First Name *
Your Last Name *
Professional Abbreviations
Mobile Phone Number *
Please provide your mobile phone number, including area code. This is only used internally, if we need to contact you personally regarding your membership.
Membership Level
Are you interested in advertising your business?
Perk: Members get discounted advertising rates. Would you like to discuss advertising options with a HAA representative?
Member Profile Verification *
Visit your profile on to verify that your member profile listing is up-to-date.
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