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Enter Your Personal Details

Signing up for the Trial Offer is a 3 step process - when you are satisfied with the details you have entered simply click on the Save and Continue button to move onto the next step.

The first month of the Silver and Gold levels are Trial Months, but remember whichever you choose you can quit at any time you wish . . .

Please complete all the fields marked with *

Select the Membership Level you wish to join:  *
Silver     Trial Month: £7.50 (€9 / $10)
        then monthly at £36 (€42 / $47) per month
Gold     Trial Month: £7.50 (€9 / $10)
        then monthly at £72 (€85 / $94) per month

Discount Code   If you have a code, enter here or leave blank
Username *
Username must be between 4 and 20 characters with no spaces
Password *
Password must be between 8 and 20 characters with no spaces
 
Title
First Name *
Last Name *
Gender *
Date of Birth *
   
Practice
Address *
Town/City *
County/State *
Postcode/Zip *
Country *
   
Telephone *
Mobile
E-Mail *
Re-enter E-Mail *
   
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I agree to the Terms & Conditions of the Chiropractic Heaven website *  Please tick
Please enter the 4 digit number:    *
 

Terms & Conditions


Click to read the Terms & Conditions of the Chiropractic Heaven website