Online RICTAT profile update form

Please only update the fields that need to be changed.

* Required Field
Name: *
RICTAT registration number *
Business name as you wish it to be displayed:
Business website address:
Business telephone number including the country code:
E-mail Address: *
Business email address (if different from above):
Country that your business is in:
County, province or state that your business is in
Business address 1:
Business address 2 (if applicable):
Business address 3 (if applicable):
Company insured with:
Insurance number:
What colon hydrotherapy equipment do you use, including the make if applicable? (open or closed inc gravity or pressure device):
What parts of your client kit are fully disposable? Speculum
Water inlet tubing
Waste tubing
What other therapies are you trained in and practice regularly?
Why do you believe that you are an integrative colon hydrotherapist? (Personal statement for your web page, 500 words maximum):
Are you attaching the photographs for your personal web page on the RICTAT website? (you, your colonic room, your clinic etc), or will you send them later? Yes
No
Attach a File:
Submission date: *