Professional Connections Inquiry Form
At Bricolage Wellness, we love working collaboratively with like-minded wellness practitioners and strive to create a strong network of providers with whom we can consult, partner, refer, and learn. If this sounds like what you or your organization is looking for, please complete this form and one of our staff members will be in touch!
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Name of person or organization *
If an organization, please specify the contact person.
Phone Number *
Email address *
What is(are) your area(s) of expertise? *
Required
What are your practice/business location(s)? *
Do you have any hospital affiliation(s)? *
If so, please specify which one(s) under "Other."
What population(s) do you serve? *
Required
What insurance(s) do you accept? *
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