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Integrative Pelvic Therapy Mentorship
Welcome to Integrative Pelvic Therapy! It is my goal to create and environment where everyone can feel safe and connected to themselves and each other during our time together. Please answer the questions below to help me create this supportive environment for your learning.

Once I receive your application. I will get back to you as soon as possible.
Email *
Name *
What is your phone number?
What location are you interested in?
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What type of practitioner are you? Please list credentials: *
Have you ever received pelvic floor work? *
Have you participated in any other pelvic floor training programs? Please list:
What are your goals for this mentorship?
Is there any thing I should know about your personal history (previous trauma, physical issues, pregnancy, etc.) that may prevent you from receiving pelvic floor work from fellow students?
Anything else you would like me to know?
Vegetarian lunches are provided during the mentorship. Do you have any dietary restrictions?
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