Submit your information below to signup for the PERQUE Integrative Health Academy Course 3
First Name*
Last Name*
Email*
Clinic or Pharmacy Name*
Practitioner Credentials*
Years in Practice*
Services Provided*
Delayed Allergy Testing
Nutritional Counseling
Supplements
Chiropractic
Acupuncture
Massage
Dentistry
Other
What do you want to get out of this course?*
Which certification programs have you completed?*
IFM
CIM
FMU
Well Guard
Other
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