Shiftboard: Synergy Wellness Registration

ScheduleFlex Help

Registration: Synergy Wellness

If you have already registered for access to our online scheduling system and you have already received your welcome email message with your temporary password, please sign in using that password.

If you have not completed this form, thank you for taking a moment to complete and submit the following details.

Thank you for your patience, it might take a few hours or days until your registration has been processed.

* required field

* First Name

* Last Name

* Email

* Primary or Home Phone

* Mobile Phone

* Address

* City

* State/Province

* Zip/Postal Code

Country

* License Type

Other

* License Expiration Date

* CPR/First-Aid Certified

Yes No

CPR Expiration Date

* Shirt Size

* Do you speak Spanish?

Yes No

* Date of Birth

* Emergency Contact Name

* Emergency Phone Number

Emergency Contact Relationship

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We appreciate your time and interest

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