Fluence - Group Course Application 2.0

This application form is for the Fluence Reading & Study Groups and Clinical Consultation Groups.

Name(Required)

Email(Required)

Are you currently enrolled in one of our Certificate Programs or a recent graduate (within 3 years of program completion)?(Required)

Yes

What group are you applying for?(Required)

What is your clinical experience?(Required)

Please tell us a little bit about your practice or profession, and what you hope to get out of this group.(Required)

Professional Website (optional)

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