A few quick questions about how you practice today and the practice you want, so your advisor comes to the call prepared.
*All questions are required.
Choose all that apply.
We won’t contact your employer without your permission. We’re asking to understand your current practice model.
If you see patients in more than one place, choose each.
Select the states where you intend to practice. Then, for each one, tell us whether you can practice independently or need a collaborating physician (if you are a nurse practitioner, whether you have independent practice authority there), and whether you hold an active DEA registration there.
Choose all that apply. Personal accounts are fine if you’re comfortable sharing them, so we can see you in action.
Where should we reach you?
See our privacy policy.