Cure On Tour - Doctor Web Site Registration

Physician Registration

Please use the form below to sign-up with the CureOnTour physician partner program. Sign-up will keep you informed about current and new services from CureOnTour. In addition we will give you access to special section of the CureOnTour site. All qualified physician will also be published on the CureOnTour Post-op and Pre-op doctor directory to be available for patients that are seeking a local Doctor before or after the medical travel.

ALL fields with a yellow background are required for the registration. However, for best support complete the whole form.

Email Address

Re-type Email Address

Password

Re-type Password

Account notices will be sent to this email address, include new password requests.
Password must be six characters or more. Do only use A-Z or 0-9 and no special characters

First Name

Last Name

Title

Company Name

Country

Telephone

Add me to periodical CureOnTour Newsletter

By registering, you acknowledge that you understand, and agree to, the CureOnTour Privacy Policy and Terms of Use.. By registering, you also consent to receiving occasional mailings and promotions from CureOnTour.

Remember if you have any questions or comments, please feel to contact us directly.

Once you have completed and submitted the form, you will be subject of approval. To do this you will receive a call to discuss the options. After you are approved you will get an e-mail informing you that the login is activated.