Clinical Registration

QEEGMaps

Clinical Account Registration Request & Practice Verification Portal

QEEGMaps software is strictly for valid clinics, healthcare providers, and clinical practices. All accounts require verification and clinical approval before account features are activated.

💡 Without a standard license number? If your clinic, board, or jurisdiction does not issue a standard license number (or if you operate an specialized clinical facility), please enter your NPI or local registration ID in the License field, and use the Practice Description & Eligibility Explanation box below to explain why your practice is eligible for access.

Do not fill this Leave blank

1. Practice & Clinical Information

Official Clinic / Practice Name *

Enter your official clinic or practice name. This exact name will appear on all generated QEEG patient report headers.

State / National Professional License # *

State or National Professional License # (Chiropractic, Medical, Psychology, Neurofeedback, Acupuncture, etc.).

Clinic Phone Number *

Clinic Contact Email *

Clinic Physical Address *

Practice Description & Eligibility Explanation

If you lack a standard license #, please detail your practice setup, clinical certifications, or clinical background here for admin review.

2. User Account Credentials

User Account Handle / Username *

Account Password *

Min 10 characters. Must include letters and numbers.

Confirm Password *

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