Use form below to add a physician profile to the Find-A-Doctor locator.

If you require additional assistance, contact:
E: info@tenexhealth.com
P: 949.454.7500

 

Doctor Finder Profile Form


[[[["field33","contains","yes"],["field33","contains","y"]],[["show_fields","field29,field30,field31,field43,field44,field45,field46,field47,field48,field49,field50"]],"or"],[[["field36","contains","yes"],["field36","contains","y"]],[["show_fields","field40,field38,field39,field42"]],"or"],[[["field50","contains","yes"],["field50","contains","y"]],[["show_fields","field51,field52,field53,field54,field55,field56,field57,field58,field59,field60"]],"or"]]
1 Step 1
Submitted by
Physician information
Facility(s) where procedure is performed (provide Account No. if applicable)
Practice Information (Location 1)
Practice Information (Location 2)
Practice Information (Location 3)
Additional Information
Treatment Areas
Number of completed cases done using the Tenex Health TX System (for internal use only, must be >5 to be added).
Upload Physician Headshot
keyboard_arrow_leftPrevious
Nextkeyboard_arrow_right
FormCraft - WordPress form builder