Find Your Place at Vitaera
Ready to be part of the Vitaera Suites ecosystem? Tell us how you'd like to connect. Whether you're interested in practicing virtually, establishing an in-person presence, bringing programming to the Well House, or exploring a partnership, we'd like to learn more about you.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Website or Professional Social Media
Organization Name
Enter the name of your company organization
Organization Name
Which best describes you or your organization?* Allow multiple selections where appropriate.
Physician / Medical Provider
Nurse Practitioner / Advanced Practice Provider
Behavioral or Mental Health Professional
Dental Professional
Allied Health Professional
Nutrition / Dietetics Professional
Wellness Practitioner
Aesthetic / Beauty & Wellness Professional
Health or Wellness Entrepreneur
Nonprofit / Community Organization
Healthcare Organization / Health System
Food / Culinary / Nutrition Organization
Corporate / Employer Wellness
Government / Public Health
Investor / Financial Partner
Community / Strategic Partner
Other: ______
Where is your business/program currently operating in Baltimore City?
Yes
No
Briefly tell us about the services, programs, or population you serve.
The Most Important Question
How would you like to be part of the Vitaera ecosystem?*Allow multiple selections.
☐ Start Virtually — I'm interested in offering services through Vitaera's telehealth ecosystem.
☐ Practice at Vitaera — I'm interested in leasing an in-person Vitaera Suite.
☐ Hybrid Practice — I'm interested in both telehealth and an in-person Vitaera Suite.
☐ Program at the Well House — I'm interested in delivering health, wellness, nutrition, culinary, or community programming.
☐ Partner with Vitaera — I'm interested in sponsorship, community partnership, institutional collaboration, investment, or another strategic relationship.
☐ I'm Exploring — I'd like to learn more before deciding.
If You Select Telehealth or Hybrid
Answer N/A in this section if these questions do not apply to you.
Are you currently providing telehealth services?
Yes
No
In development
Previously offered telehealth
N/A
What services would you be interested in providing virtually?
If this does not apply to you, insert N/A
Are you currently licensed/credentialed to provide your professional services?
Yes
In process
Not applicable to my profession
I'd like to discuss requirements
N/A
When would you be interested in beginning virtual services?
As soon as possible
Within 30 days
Within 60–90 days
Within 3–6 months
I'm gathering information
N/A
If You Select Vitaera Suite or Hybrid
Answer N/A in this section if these questions do not apply to you.
What type of space are you interested in?
Dedicated private suite
Part-time/flexible space
Telehealth + physical suite
Not sure — I'd like to discuss my needs
N/A
What type of services would you provide from your Vitaera Suite?
If this does not apply to you, insert N/A
When would you ideally like to establish your physical practice?
As soon as Vitaera Suites opens
Within 3 months of opening
Within 6 months
Within 12 months
I'm currently exploring
N/A
Would you like to learn more about becoming a Vitaera Founding Provider?
Yes
Maybe — send me more information
Not at this time
N/A
Program at the Well House
What type of programming are you interested in bringing to the Well House? Allow multiple selections:
Food is Medicine
Healthy Cooking / Culinary Education
Nutrition Education
Diabetes Prevention / Management
Weight Management
Maternal Health
Youth Health & Nutrition
Senior Wellness
Behavioral Health / Mental Wellness
Community Health Education
Practitioner-led Workshop
Wellness Event
Other: ______
N/A
How often would you potentially use the Well House?
One-time program
Monthly
Quarterly
Multi-session series
Ongoing programming
Not sure yet
N/A
Are you interested in discussing 2027 programming opportunities?
Yes — I'd like to reserve/program dates
Yes — I'd like a planning conversation
Possibly — send me information
Not yet
N/A
Does your organization currently have funding for programming?
Yes
Funding is pending
Seeking sponsorship/funding
Not applicable
Prefer to discuss
N/A
Final Questions
What would you like your next step with Vitaera to be?*
Schedule a Telehealth conversation
Schedule a Vitaera Suite consultation
Discuss the Founding Provider opportunity
Schedule a Well House programming conversation
Discuss partnership / sponsorship opportunities
Send me additional information
I'm not sure yet — please contact me
How soon would you like us to follow up?
As soon as possible
Within 48 hours
Within one week
I'm just gathering information
Is there anything else you'd like the Vitaera team to know? (Optional)
Stay Connected
Yes, I'd like to receive updates, opportunities, events, and information from Vitaera Suites.
Submit
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