Patronship & HPx Program Registration FHCi

Free and Healthy Children International Patronship & HPx Program Registration

By completing this registration with FHCi I affirm: I am voluntarily registering as a Patron of FHCi on behalf of myself, my spouse or partner and/or my dependents without any pressure or promise of cure of disease or disease prevention. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I affirm that if I do belong to any media outlet I will not misrepresent any information regarding homeopathy or homeoprophylaxis. I affirm that I will not carry out any mission of entrapment or investigation.
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Name*

First NameLast Name
Email*
example@example.com
Phone (Country code for USA & Canada +1) *

Country CodeArea CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
FHCi HPx Supervisor/Practitioner's Name*

First NameLast Name
Your FHCi HPx Practitioner's Email*
example@example.com
These donations enable FHCi to bring you these programs and maintain our research data base. You are investing in a healthier future for all. Thank you!

FHCi HPx Program registration fees are per program and per person for up to 8 members in the same household. Please select one or more HPx Programs* for yourself or immediate family members. This is the registration fee only, Kit and HPx Practitioner fees are additional. This is the FHCi registration fee only, and is non-refundable.

* An HPx Program is a sequential dosing series targeted for specific age groups and their immune system maturation to be taken over several weeks to months.

*The Single Disease HPx is for current out breaks of infectious disease regardless of age.

HPx Program registration instructions:
- The Patron Registration is a onetime fee for the entire family for up to 8 family members in the same household.
- FHCi HPx Program registration fees are per program and per person for up to 8 members in the same household.
- Select the number of family members enrolling in the selected HPx Program.
- Selection of 1 Full Childhood HPx Program covers all children enrolled at this time.
Please let us know how you learned about Homeoprophylaxis*

Online searchSocial MediaMy HomeopathFamilyFriend/Neighbor/Co-workerDoula/MidwifeMy medical doctorOther
We want to know who is represented in our community. Please let us know who you are*

Professional mom or dadHealthcare practitionerHomeopathNaturopathProfessional birthing fieldMedical DoctorEducation with young childrenSpecial educationLegal advocateSocial media/influencerTech/computer expertResearchNone of the aboveOther
Please let us know below how many adults and children will be participating in HPx Programs.
Number of Adults
Number of Children
Please select the HPx Programs below and select how many people will be participating:*
prevnext( X )
Patron Registrationpay for only 1 registration per family
$45.00 Quantity



1. Healthy Biome HPx ProgramAll ages; 9 weeks
$15.00 Quantity



2. Full Childhood Immunological HPx ProgramPay for only 1 per family; infant to 18yers of age; 50 months
$15.00 Quantity



3. Young Adult and College Prep HPx Program17-25 years of age; 6 or 12 months
$15.00 Quantity



4. Travel HPx ProgramAll ages; 5-15 weeks
$15.00 Quantity



5. Healthy Sexuality and Pre-Procreation HPx ProgramAges 16-35; 7 or 14 months
$15.00 Quantity



6a. Group B Strep Prevention in PregnancyBefore and during pregnancy.
$15.00 Quantity



6b. Group B Strep with Poly-Metal add-onBefore and during pregnancy
$15.00 Quantity



7. Healthy Pregnancy and Fetal Development HPx ProgramBefore conception through pregnancy; 7 months
$15.00 Quantity



8. Immune Health for Elders HPx Program55 years and older; 6 months
$15.00 Quantity



9. Seasonal HPx Seasonal upper respiratory illness; all ages
$15.00 Quantity



10. HPx for Tick-Borne IllnessHPx after Tick bite; all ages.
$15.00 Quantity



11a. Single disease prevention/treatment with HPxAll ages; 2-5 weeks. Choose this for current disease outbreaks
$15.00 Quantity



11b.InfluenzaAll ages; seasonal
$15.00 Quantity



11c.PneumoniaAll ages; seasonal
$15.00 Quantity



11d.MeaslesChildren and anyone without natural immunity during outbreak
$15.00 Quantity



11e. ChickenpoxChildren and anyone without natural immunity during outbreak or as booster
$15.00 Quantity



11f. Whooping CoughAll ages
$15.00 Quantity



11g. CovidAll ages
$15.00 Quantity



Total

$0.00
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By completing this form, I understand that*

I have registered for access to these Homeoprophylaxis programs.All payments submitted are donations to FHCi and are nonrefundable, regardless of my participation or completion of any of these programs.
Thank you for supporting FHCi, and this important work!
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Free and Healthy Children International Patronship & HPx Program Registration