Practitioners

Name

Email Address

Phone Number

What certifications/trainings do you hold? *

What are you interested in teaching * What are you interested in teaching * Ballet Barre Yoga Pilates Other

How did you hear about us? * How did you hear about us? * Website Friend Referral Social Media Other

Have you ever taken a class at Holistic Healing Center? * Have you ever taken a class at Holistic Healing Center? * Yes I've only participated in a workshop/event Not Yet

When are you generally available to teach? *

What do you love about teaching? *

Please share with us what Pharm values you feel you most align with? *

Who are some of your teachers and/or mentors? *

What does Community mean to you? *

How do you support your community? *

Anything else you want us to know *