Name *

First Name

Last Name

Phone *

(###)

###

####

Time Zone *

What time zone are you located in?

Pacific (PST)

Mountain (MDT)

Central (CST)

Eastern (EST)

Can we text you? *

Yes

No

What type of health professional are you seeking to become within our network? *

Select all that apply.

Health & Wellness Coach

Nutritionist / Dietitian

Physical Therapist

Massage Therapist

M.D. / Holistic Doctor / Naturopath

Fitness Trainer

Health Coach (Reg. Nurses also fall under here)

Life Coach

Chiropractor

Acupuncturist

Dentist

Business Coach

Specialized Health Pro (Field not listed here)

Do you have your own health practice? *

Yes, I currently have my own practice

No, but I'm interested in having my own health practice

No health practice at the moment

Do you have your own website? *

Yes, I have my own website

No, but I would like my own website

No website at the moment

What type of marketing have you done for your own practice? *

Check all that apply

SEO

Content Marketing / PR

Email Marketing

Social Media Marketing

None of the above

This is a health professional network, where we help you build out your own practice or help you attain more clients. This is not a paid salary position or job offer. Do you wish to proceed with this opportunity to learn more? *

Yes, I'd like to learn more

No, this isn't for me.

To move forward and secure a year-long partnership with us, there is a cost involved, which can be made more manageable through a payment plan of $99 or less per month. Does that sound feasible for you? *

There is a small monthly cost involved to get started with us, which goes towards building up your site/profile, maintenance on it, consulting support, your paid in full payment integrations, directory listing, SEO management, and blueprint strategy guide. Please look at Step 4 for full breakdown of pricing and services included.

Yes, I'm okay with the cost and it is feasible for me.

No, I'm not okay with the cost, this isn't for me.