Registration for The Catalyst Collective
To keep this group in alignment with the core values of honesty, creativity, and curiosity to help eradicate burnout in the healthcare profession, we are asking confirmation of your licensing.  **NONE OF YOUR INFORMATION WILL BE SHARED OR SOLD**.  This registration is merely to keep our facebook group as clean as can be (free of bots, people unrelated to healthcare, etc)

After submitting this form, you will get the secret password to enter into the Facebook Group on the "thank you" page.  Please ask to join the group again and you'll be admitted.  :)

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Email *
First name *
Last name *
Provide your name/alias (as appears) on Facebook so we can recognize you to let you in: *
What school and year did you graduate (or will you graduate) from? *
What licensing do you hold?  We accept all healthcare fields (eg. MD, DO, DC, ND, NP, LAc, PsyD, LSW, PA, EMT, etc) *
Thank you! When you click the button, you will receive the SECRET PASSWORD on the next screen!  :)
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