PulseConnect Registration
First name
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Last name
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Email
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Company
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Professional Title
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Address Type
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Home
Office
PO
School
Street Address
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City
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State
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Zip Code
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Please indicate your license titles:
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CDCES
CMA
CNM
DO
DTR
LDN
LPN
MD
MPH
ND
MS
NP
PA
PhD
PharmD
RD/RDN/LDN/CDN
RN/APRN
RPh
Other
What best describes your primary specialty?
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What best describes your secondary specialty?
Which best describes your primary work setting?
How many people do you counsel, coach or advise per week?
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On which of the following topics do you regularly counsel patients or clients?
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Which of the following do you use for your professional work and/or to share health and wellness information?
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Blog
Facebook
Instagram
LinkedIn
Local Newspaper
Local TV
TikTok
X / Twitter
None of the above
What percentage of your patients or clients are Spanish-only speakers/readers?
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What percentage of your patients or clients qualify for/are on WIC?
How do you see patients?
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Both in person & virtually
In person
Virtually
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