First Name
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Last Name
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Email
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Type of Practitioner
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Years of Experience
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0-1
2-4
5-10
10-20
20+
Retired
What Are Your Goals With This Program?
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Cohort Dates (Pick One)
April 2025
Not sure yet
Location (time zone)
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Referred by (for example: QBC email, Carrie Bennett, Dr.Leland Stillman, ect.)
Why are you excited to study applied quantum biology?
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I understand that this is a practitioner training and is not the appropriate space for help with personal health problems
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Yes, I understand
No, this doesn't quite make sense to me
I understand that this certification teaches the foundational principles of Applied Quantum Biology that underpin human health
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Yes, I understand
No, this doesn't quite make sense to me
I understand that if I am new to the field of health and wellness, I will require some additional training, for example a coach training program
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Yes, I understand
No, this doesn't quite make sense to me
What questions do you have for us?
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Submit