Practitioner Application Form
Thank you for your interest in joining our network of practitioners! We are so excited to learn more about you.
Email address *
Name *
First and last name
Your answer
Phone number *
Your answer
Business Address *
Your answer
Would you be willing to go to disabled client's homes? *
What services do you offer? *
Your answer
Are you willing to do any complimentary sessions? *
What rate are you willing to work for? *
Your answer
How many sessions per week would you like to offer at this rate? *
Your answer
Do you have any special training to work with specific illness' or health issues? *
Your answer
Would you be interested in selling Blessed are the Flexible products to help support the nonprofit and bring in a little revenue for yourself? *
A copy of your responses will be emailed to the address you provided.
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