Please Complete This Short Application To See If You Are A Good Fit For Our Program

*Applications are confidential.*

Full Name *

What state will you open your Aesthetic Practice in? *

Are you a Registered Nurse or Nurse Practitioner? *

Registered Nurse

Nurse Practitioner

What is your current specialty? *

What actions (if any) have you taken at this point to start your Aesthetic Practice? *

What is one fear you have about starting your Aesthetic Practice? *

Our mentorship program is for nurses, nurse practitioner and doctors who are looking to start their practices on the side, is this what you are looking to do? *

Yes

What is the current monthly income? *

$3000 below
$4,500 - $6000
$6000 - $10,000
$10,000+
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What do you feel is the biggest challenge you’re currently facing when it comes to starting your Aesthetic Practice? *

We have limited spots for our Medspa Startup Bootcamp, If you are accepted into our program, would you be ready to take action now to secure your spot?

Yes, I was ready like yesterday

Yes but I'll be ready within a week

Yes but not right at this moment. I'll be ready in the next few months

No, I don't want to secure my spot at all

Dr. Jones is extremely passionate about working with nurses who will be successful in her program. Her track record precedes her and she is very selective about who she works with. If accepted into the program, are you willing to dedicate at least 5 hours per week during the Bootcamp to build your Aesthetic Practice? *

Yes

Do you have a partner or significant other who you will need to speak with to make a decision to invest in your personal development?

Yes - (If so, only schedule the call when they are available to be on with you)

How much money are you willing to invest in working with a business coach to teach you the blueprint and process to owning a Medspa as a nurse?

$3000/below

$5000 - $10000

$10000+

If you were to find a program that you feel would work for you to learn how to successfully open your own Medspa as a nurse, would you be open to financing to learn how?

Yes

Are you an RN or NP?

What is the estimated range of your current credit score?

720+

680 - 720

640 - 679

550 - 639

550 or below

Provide Your Instagram Handle *

Ok great it seems like you might be a good candidate that we could possibly help. What is your email? *

Thank you, what is your phone number? *