Apply for a Wellness Suite at GROWS

This application is for qualified, licensed wellness providers interested in joining our community suites. Please provide detailed information about your practice below.

Wellness Provider Application

Please complete all fields below to apply as a wellness provider. We'll review your application and be in touch shortly.

Legal practice name

Applicant/provider name

Telephone

Profession and license number

Years in practice

Current clientele and preferred schedule

Services offered

Space/equipment needs

Requested start date

Website/social links

Insurance status

Insurance details

I am interested in participating in workshops and continuing education opportunities offered by the facility.

Workshop/education interests

I agree to provide a completed W-9, valid professional license, and proof of insurance upon preliminary approval of my application.

I consent to be contacted by the wellness center regarding my application and future opportunities.