Please complete the form below. After you have filled in the form, you will be re-directed to our Linkedin community page to join the group. You will need to be actively in practice and have an active Linkedin account to join the conversation. Welcome!
Other (please specify below)
My Practitioner Type was not listed above. My Practitioner Type is:
Percent of Practice Devoted to Functional Medicine
Are You IFM Certified
Best Contact Email
Best Contact Phone Number
Practice Location: City
Practice Location: Zip or Postal Code
Practice Location: State or Province
Practice Location: Country
Is Your Practice Virtual?
Fee for Service
Direct Primary Care
Hybrid (please describe below)
If Your Business Model is a Hybrid Model, Please Describe Below, otherwise skip:
Mixed, please describe below
My Reimbursement Model is Mixed, and Described Below. (If does not apply to you, please skip)
Previous Research Experience
Are you a Previously Published Author on Case Studies or Research?
Are You a Current User of the Living Matrix Software?
Please answer the following questions if you are NOT a current user of the LivingMatrix Software.
Does Your Practice Have A Specific Focus or Condition Specialization?
Age Range of Patients Seen?
Number of New Patients Per Month?
Do You Use Any Kind of Validated Instruments (like PROMIS) to track patient outcomes? Please describe.
Do Not Fill This Out