NP MHT/HRT Fundamentals & Clinical Partnership Form Name(Required) First Last Email(Required) Phone(Required)Professional Designation(Required)Nurse Practitioner (NP)Physician (MD/DO)Registered Nurse (RN)Naturopathic Doctor (ND)Student / ResidentOther Healthcare ProfessionalPrimary Province / StateOntarioNova ScotiaAlbertaBritish ColumbiaOther Canadian ProvinceUnited StatesHow can we support your practice?(Required) Enroll in / Get notified about the MHT/HRT Fundamentals Course Refer midlife/cancer survivor patients for functional hormone care Learn about Advanced Pellet Therapy Certification Participate in the Canadian Provider Midlife Care Survey (Select all that apply)Practice Name / Additional NotesEmail Opt-In(Required) Yes, send me clinical updates, course modules, and Canadian provider guidelines.
