Registration – Animal Herbal Medicine

Personal Information (Private, Not Public)

Name
Email(Required)
Address

Practitioner / Business Information (Public)

( *This information will not be displayed if you opt out of the public practitioners directory. )
Address to be Displayed in Practitioner Directory
If applicable
If applicable. NOTE: Website addresses must begin with https:// followed by your domain.
Species Treated

Personal Information (Private, Not Public)

College Registrations

Association Registrations

Please upload the following documents:
Drop files here or
Max. file size: 20 MB, Max. files: 10.
    Note: Depending on your browser, the file selection dialog may remain open after you've selected your files for upload. If this occurs, once you've selected your files and uploaded, cancel the dialog if it remains open, and confirm the files are listed below. If there are duplicates, you can use the trash can icon beside each to delete the duplicate uploads before submitting the form.
    Degrees, Diplomas, Certifications, or Course Certificates relevant to the animal health practice.
    Professional Liability Insurance
    Drop files here or
    Max. file size: 20 MB, Max. files: 2.
      Insurance company name, policy number and policy showing name of practitioner, confirming minimum of $1 million liability.
      Application and documentation will be reviewed by the Registrar and Practice Registration Review Committee. You may be asked to provide further information to complete your registration. Upon application approval and submission of full registration fee, you will become a registrant of RAAHP.
      Do you wish to be included in the public practitioners directory?(Required)