Your Clinic Info

Clinic Name*

Clinic Director*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Fax*

Clinic Email Address*

Directions to your Clinic*

The more detailed the better! Use key community & neighborhood words within your directions.

Affiliation Type*

Private

Hospital Affiliated

If hospital affiliated, which hospital?*

Information for Google & Yelp

Hours*

What hours is your clinic open? These should be the hours that someone will be in your clinic to physically answer a phone call. Please give us hours for Monday through Friday and any additional Saturday hours.

Does anyone in your clinic speak any other languages besides English?*

Check all that apply.

English Only

Spanish

Mandarin

Sign Language

Other

If you chose "other", please tell us which one.*

Does your clinic have a ...*

Check all that apply.

Unisex Restroom

Wheelchair Accessible Elevator

Wheelchair Accessible Entrance

Wheelchair Accessible Restroom

Services Information

Clinic Services*

Select all that apply.

Clinician Info

Clinicians in your clinic*

Please list any clinicians who may treat in your clinic.

Community Information

Athletic Training Coverage*

Please list any partnerships where we provide an athletic trainer for a local high school, college or sports program.

Other community partners*

Please list any other local club sports or community partners you spend a significant amount of time with. This can include gyms, running clubs, etc. If you have links to these partners, please share below!

What other nicknames does your area, city or neighborhood go by?*

We want to know what the locals call your area, please include all nicknames, points of reference, or anything else you think we need to know to write content to target your clinic's neighborhood.

What makes your clinic special? (special equipment, ideal location, special training, etc.)*

What else?*

Let us know anything else about your clinic or patient population that might be useful to know. Fun facts about your city, large sports demographics, anything we could write about to make your page hyperlocal. Example: If your city holds major tennis tournaments, we will write more about tennis injuries or showcase blogs that might help with elbow pain, etc.

Pictures for Google & Website

Photos of your clinic & team

Please send a few photos that represent the culture of your clinic. These can be clinic shots (exterior and interior), group shots of your team from in the clinic or out in the community, etc.

Drop files here or

Max. file size: 50 MB.

CAPTCHA

Tell us about your clinic!

Information for Google & Yelp

Services Information

Clinician Info

Community Information

Pictures for Google & Website