Spirit of Service: Volunteer!

Please fill out the form below if you're interested in volunteering.

Practitioner Name:
Contact Phone:
Email:
Services you will offer:
Licenses and/or certifications:
Do you currently have an office/practice space? (If not, we do have a few spaces available for volunteering practitioners)	Yes No
Please specify your availability	1-2 sessions per week 1 session per week 2 sessions per month 1 session per month Other:
Would you like your name to be included on a provider list that we will circulate to other providers in the network for the purpose of contacting one another to trade services?	Yes No
This is all the information we will need at this time. We will be contacting you within two weeks of receiving your form. We can not thank you enough for taking the time to review our material and for volunteering your services to those members of our community who can benefit greatly from the healing properties of alternative medicine practices.