We need the following documentation before you can treat a client. Please email to jacob@bigislandmassagenetwork.com

Government issued photo ID (Drivers License, ID Card, Passport, etc)
W-9 (Blank Form)
Malpractice Insurance Policy (showing coverage dates)

When we are ready to put you on the website, we’ll need a headshot photo for the page showing all the therapists in your area. Then for your own therapist page we can use the same photo or another one that shows a your whole upper body. Photos need to crisp and well lit. Make sure to clean your lens! Must be appropriate for a medical context. For many of you who are starting as a backup, we won’t need this right away.

We need the information below to get started:

Legal Name

This name must match your massage license and your insurance

First Name

Last Name

Preferred Name

Massage License Number

NPI

If you don't have a NPI, we can apply for one on your behalf. Having one makes billing go much more smoothly.

BIMN announcement email list

Important emails will go out to all therapists...but there are some optional emails for things like office shares, creeper alerts, tax reminders, etc.

Phone # for communicating with BIMN

(###)

###

####

Phone # for clients

(###)

###

####

Client number public?

A public number might help get more clients as well as non insurance massage, but no pressure if privacy is super important to you.

If either is a land and can't receive texts, let us know

Mailing Address

Practice Address

What days do you work at this location?

Practice Location Description

Please describe parking scenario in detail

Obscure my address on therapist map

If location is obscured, tell us exactly where to put the pin on the map.

I am available for outcall in the following areas:

Anything else you want to tell us?

Therapist Info Form