Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Name
Email Address
example@example.com
Website
Instagram or other social media
Please explain your onboarding process.
Do you talk to your patients about drainage pathways
Yes
No
Not currently, but interested in learning more to better understand importance
What is a herx reaction?
What can you do prevent herx reactions?
What would you recommend to a client who is experiencing a herx reaction?
Do you provide time for education?
How do you know when to recommend Ozone Therapy?
Talk me about the ingredients in your IV solutions. What is important to you about how your bags are prepared, what quality ingredients are using, what do you avoid?
Please describe your philosophy (ie. throw the kitchen sink, low and slow, order of operations, ect.)
Which of these options describes your level of education?
Registered Nurse
Medical Doctor
Doctor of Chiropractic
Naturpath
Other
Please list any certifications or trainings you have received in ozone therapy, if any. (Who is your mentor?)
Is there anything else you would like us to know about your practice?
There is a one time fee of $50 if your application is approved. Do you agree to pay?
Yes
No
I'm a certified NIP Nurse! (no fee)
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