Request Your FREE Application
'Starter Kit' By:

By E-Mail
[Click Here To Request Application]

By Fax
We Can Fax You A Secure User Name & Password Link.
Call (770) 455-8190 x 137 - (800) 816-2671 x 137.

By Phone
Call Us @: (770) 455-8190 x 137 - (800) 816-2671 x 137

Instructions
Please provide your name, specialty (i.e. chiropractic, massage, nutrition, etc.), how many kits you need, your telephone number and mailing address. Providers who join Soteria must also have at least two years of practice experience. Some exceptions may apply if less than two years.

Because we value your privacy, your 'Starter Kit' will contain a secure link to your On-line Application. This link will enable you and/or your Office Staff to complete the process much quicker and more accurately. Once filled out and attached with the necessary documentation, simply "print and mail" the materials back to us (Note: original signatures required - no copies). It's that easy!