Creating Confidence Program Application

Thank you for taking the time to fill out this application for our foundational program!

Please note: This program is only for health & wellness professionals/practitioners/coaches who currently or plan on working with clients. This is not a program for the general public & this program does not offer medical advice.

Full Name *

Email *

Phone *

Which profession, occupation or educational background best describes you? *

Health Student

Holistic Nutritionist

Nutritionist

Naturopathic Doctor

Naturopath

Health & Wellness Coach

Personal Trainer or Kinesiologist

Other Health Professional

I am not a health or wellness professional

Have you completed anatomy, physiology & pathology classes during your education? *

Yes
No
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How much experience do you have in your field? *

0-1 year

1-3 years

3-5 years

5-10 years

10+ years

How comfortable are you with lab work analysis? *

I do not currently use lab work in my practice
Clients give me their labs, but I feel uncertain about them
I use labs occasionally in my practice and have a basic understanding
I currently use labs & want to upgrade my knowledge
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What are you hoping to get out of this course? i.e what are your goals? *

How did you hear about us? *

Direct referral from Larissa
Instagram
Google
Educational institute/ School
A colleague
A friend
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Yes, I Consent

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