Welcome to the Modi Health practitioner platform. This is your virtual office set up.

Please download and complete the forms below and then upload the required documents. Also, please set your schedule below. You can update your schedule at any time.

DOWNLOADS

Practitioner Info Sheet

Practitioner Video SpecificationsModi Release Form – Wellness Practitioner Agreement

For medical doctors please use the following release form:
Doctors-Modi-Release-Waiver-of-Liability-Indemnity-Agreement-1756141

W9 Tax Form

Practitioner Video Guidelines

Practitioner Video Agreement

UPLOAD DOCUMENTS

HEAD SHOT

COMPLETED FORM

PROOF OF CERTIFICATION AND/OR LICENSE

PROOF OF INSURANCE

SIGNED RELEASE FORM

W9 TAX FORM

EDUCATIONAL VIDEO AD
*By choosing to upload your video you give us the right to add this video to our membership platform as well as use it in whole or part to advertise.

Click here to upload documents.

The timezone displayed is as per your desktop timezone settings.