List any past medical or psychological conditions, including injuries and hospitalizations:
List any medications, nutritional supplements, herbs, and vitamins you are taking.
Are you currently under treatment with a Doctor, Chiropractor, Osteopath, Naturopath, Bodyworker, Acupuncturist, Polarity Practitioner, or other Health Care Practitioner? If so, please explain:
Why are you interested in taking this program?
Are there any special conditions that might affect your ability to complete your training or would require special treatment during the program? If so, please explain:
List/describe any complementary and alternative training you may have, or courses you have taken.
What is your educational background? Please list your traditional experience and levels completed, i.e. high school, college, graduate school, post-graduate, professional, vocational trainings, etc.