What can we help you with? *

IASIS ToolBox (CRM, Website / Domain, Automation, Marketing)

Practitioner Guidance (Treatment Planning, Clinical Questions, Purchasing)

Admin Help (Invoice / Payment, Shipping Info, Training, Agreements)

Update Find a Provider Listing

Update Contact Information for IASIS communication (newsletters, IASIS updates via text/email)

Cloud Software (Problems, Questions)

Practitioner Portal, Client App (Problems, Questions)

Find a Provider Listing Update Form

**This is the information that will appear on our website when a client is searching for a provider to receive a session.

First Name *

Last Name *

Credentials (ex. RN, MD, LPC, DPT, DC...) *

Provisional Under

Full Business Name *

Business Address (including city, state, zip) *

Business Phone *

Business Email Address *

Business Website

Market Segment (counseling, chiropractic, integrative medicine etc.) *

IASIS ToolBox Help *

CRM

Website / Domain / Email

Automation Not Working

Automation Feature Requested

Marketing

Practitioner Help *

Treatment Planning / Clinical Questions

I want to purchase another device

IASIS hardware questions

Admin Help *

Invoice / Payment

IASIS Device / Infrared / shipping

Training IVT/FOI

IASIS Agreements (DocuSign's)

Questions / Issue / Additional Information

Full Name *

Business Name

Are you an ICP or an ICT *

ICP

ICT

Email *

Phone *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.