Practitioner Application

Practitioner Application
Please Tell Us About Yourself
What is your name?*

First NameLast Name
What is your billing address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What is your preferred email address?*
example@example.com
What is your phone number? *

Country Code (001 for United States)Area CodePhone Number
How would you like your name to appear on your practitioner certificate? *
Please Tell Us Your Quantum-Touch Workshop History

To qualify as a Quantum-Touch Practitioner, you need to complete two Level 1 workshops (Virtual or In-Person) and one additional workshop (such as Level 2, Level 3, or Level 4).Please complete the form below by listing the dates and instructor names for your two Level 1 workshops. Then, provide the name, date, and instructor of your third qualifying workshop.
First Level 1 Workshop
Was the Level 1 an Online Course (Virtual) Course or In-Person? *
Please select Virtual or In-Person
Completion Date of Your First Level 1 Workshop *

MonthDayYear
Date
Instructor*
Second (Repeat) Level 1 Workshop
Was the Level 1 an Online Course (Virtual) Course or In-Person? *
Please select Virtual or In-Person
Completion Date of Your Second Level 1 Workshop *

MonthDayYear
Date
Instructor*
Third Workshop
Workshop Level*

Level 1: Becoming EnergizedLevel 2: Becoming SuperchargedLevel 3: Becoming WholeLevel 4: Becoming Heart-ConsciousLevel 5: Becoming MiraculousLevel 6: Becoming MoreLevel 7: Becoming Ageless
Was your third workshop an Online Course (Virtual) Course or In-Person? *
Please select Virtual or In-Person
Completion Date*

MonthDayYear
Date
Instructor*
My Story with Quantum-Touch
What is the main reason you decided to become a Quantum-Touch Practitioner? *
What do you love most about Quantum-Touch? *
Optional: Please write a personal bio for your Quantum-Touch Practitioner Profile (approximately 150 words). You can indicate your areas of interest or specialization relative to Quantum-Touch as well as other complimentary modalities you use.
Final Steps Toward Becoming a Practitioner

Please upload your 90-Hour session documentation, Profile Picture, and 5-Insights
90-Hour Session Documentation

Complete a minimum of 90 hours of documented Quantum-Touch sessions. The “90 Hour Session Documentation Form” can be found under Practitioner Forms on the Quantum-Touch website. Up to 30 hours may include sessions on yourself, animals, or plants. These must be individually documented (per session or per hour). Please DO NOT group these 30 hours into a single sum.
Please upload your 90 hour form here. *

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5-Insights

As you document your 90 hours of Quantum-Touch sessions, you may find new insights naturally emerging. These might include innovative ways of addressing specific conditions, unique hand positions or postures, or fresh perspectives on the work that hadn’t been considered before. This is where your creativity and personal connection with the energy can truly shine — and where your discoveries might help expand the practice in new and meaningful directions. Please note: All insights should be based solely on your experience with Quantum-Touch and should not incorporate other healing modalities.
Please upload your 5 Insights here *

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Optional: Profile Picture

Please send us a high resolution profile picture for use on your Quantum-Touch Practitioner Profile.
Please upload your profile picture here

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Should be Empty:

Practitioner Application

Please Tell Us About Yourself

Please Tell Us Your Quantum-Touch Workshop History

First Level 1 Workshop

Second (Repeat) Level 1 Workshop

Third Workshop

My Story with Quantum-Touch

Final Steps Toward Becoming a Practitioner

90-Hour Session Documentation

5-Insights

Optional: Profile Picture