Complete the form below then click the
"Submit Membership Application" button
to begin working with Dr. Davis, staff, and
the many other Inner Circle Members.

Member Information


  • Passwords may not contain the special characters (", ', *, [, ], <, >, =).
  • If your Username or Nickname continues to display as "In Use" after several changes make certain your password has not been erased.

Username (or Email Address) (must be unique)
Public Nickname (must be unique)

Contact Email Address

Password (cannot include: ", ', *, [, ], <, >, =)
Confirm Password

First Name
Last Name

Date of Birth
Birth Gender

Membership Type

Promo Code

Payment Method

Credit Card Type

Card Number

Expiration Month
Expiration Year
Card CVV

Read and Accept Terms of Use

Submit Your Application

Click the button below to submit your application. Any omissions or errors will be listed at the top of the page along with instructions on what to correct. If your submission was successful you will automatically be taken to the 'Welcome' page.

Processing may take up to 1 full minute. DO NOT refresh your browser once you click "Submit Membership Application".

DO NOT refresh your browser once you click "Submit Member Application".

To ensure privacy, all personal identifying and financial information is sent via secure, encrypted transmission. Medical information you provide when using the Inner Circle programs is only identified by your Username or Nickname.