Search Site
Home
Up

Go Shopping
Aromatherapy & Essential Oils

Herbal Products

Homeopathy

Books, CDs, DVDs

 Skin Care

Vitamins and Minerals

Miracle Blanket - Stops Colic!

 For Children

 Volcanic Clay

Contact Us
 

 

Holistic Practitioner Membership Application

Complete This Form
 

Name: 
Company:
Street Address: 
City:
State:      Province: 
Country   Other: 
Zip/Postal Code:
Phone:
Fax:
E-Mail:
   
Package Selection:
   
Practitioner Profile:  
Certification:
choose up to 3 items by holding down the <Ctrl> key
Modalities Offered:
choose up to 3 items by holding down the <Ctrl> key
Other (specify):
Practitioner Resume:

You may send your resume by e-mail to:

customerservice@atlantisnatural.com

Or by fax at:  786-513-8156
Patient Results: Please specify example results you have seen in your practice as a result of implementing your treatment protocol or healing modalities.
Yes, I would like to receive monthly updates from Atlantis Energy Network
   

Terms of this Application:
By submitting this application I understand that my educational certification and background will be subject to reasonable validation by Atlantis Energy Network.  I also understand that Atlantis Energy Network is under no obligation to accept my application and to deliver the services outlined in this website unless my background and services offered are determined to be consistent with the quality policy stated in this website.  Atlantis Energy Network may use its discretion to ensure that holistic practitioners listed on this website offer services that are complementary to one another.

By submitting this application I accept these terms.

See our full catalog of natural health products for adults and children at www.atlantisnatural.com

Copyright© 2002-2004 DIEX, LLC.  All Rights Reserved.            WE MAKE NO MEDICAL CLAIMS -
INFORMATION ON THIS SITE IS NOT INTENDED TO REPLACE THE ADVICE OF YOUR DOCTOR.  UNLESS OTHERWISE INDICATED, STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION.  PRODUCTS ARE NOT INTENDED TO DIAGNOSE, TREAT, CURE OR PREVENT ANY DISEASE.  ALWAYS CONSULT YOUR DOCTOR PRIOR TO STARTING OR MODIFYING ANY HEALTH CARE PROGRAM, IF YOU HAVE A KNOWN MEDICAL CONDITION, OR IF YOU ARE PREGNANT OR LACTATING.