*What kind of organization do you represent?
If "Other" please elaborate:
Describe briefly the type(s) of patients you see:
How many patients do you see annually?
How many staff are employed at your organization?
*Is your organization... profit or not-for-profit? (check one)
Describe briefly what your role is in your organization:
Describe briefly where you are in the process of implementing an
Integrative Medicine Program:
Describe briefly what level of support you have:
*Have you read our Building Bridges online book? Yes No
(If you haven't, CLICK HERE to view it!)
What modalities do you have and/or are interested in discussing?
What other issues would you like to discuss when we contact you?