Manage your Policy

Use the following form to update your information

If you would like to RENEW your policy, Click Here
Name*
First Last
Email*
Enter your email address. We will use this email to correspond with you.
Policy Number
Enter your policy number if you know it
Check each box you would like to update:
- Name
- Email
- Address
- Phone
- Fax
- Add Modalities

Notice
If you are renewing your policy and ALSO want to update your name and/or address, etc., you can do this as you RENEW YOUR POLICY CLICK HERE

If you are just updating your information mid-term, please continue to the next page.

Email Change
Enter your old and new email addresses in the appropriate fields below
Old Email
New Email

New Phone Number
Enter your old and new phone numbers in the appropriate fields below:
Old Phone
New Phone

New Fax Number
Enter your old and new fax numbers in the appropriate fields below:
Old Fax
New Fax

Checkmark any of the following modalities you practice below. We will require a copy of your training certificate/diploma or membership number.
- Osteopathy
- Kinesiology
- Physiotherapy
- Shiatsu
- Hot Stone Massage (must not be web-based training)
- Nutritional Consulting
- Fitness Instructor
Which can you provide us with?
- Membership number
- Training Certificate/Diploma
Upload your training certificate/diploma*
Drop files here or
Enter Membership Number:*
Enter any modalities not listed above:

Use the following form to update your information