Practitioner Profile Form - Myofascial Energetic Release Trainings

Practitioner Profile Submission

Please use this form only when you are invited to do so and only once per invitation until we let you know about the status of your profile. If you haven't read the instructions for submitting your data, please read them now..

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Name*

First Last

Are you a ... ?*

Man

Woman

MER Training Modules

What is the status of your MER training?*

MER certification requires the completion of 5 modules if you have been certified before 2019, and 6 from this date. Make note that Module 7 is optional and is not a part of the modules to be completed for certification.

I am in training

I am certified

How many training modules have you completed?

Where did you get certified?*

When did you get certified?*

When did you complete your last module?*

Where did you complete your last module?*

Sorry! We can't accept your submission just yet!

You need to have at least 3 MER modules completed before you can be listed on our website!

Where do you give your sessions? (Countries & Cities)*

You can be listed in 2 countries. To add another country, please click on the grey plus symbol behind the input field named "City". We leave it up to you to add a city to each country or not.

Country

City

Email*

Enter Email Confirm Email

Phone

Please add the country code to your number.

Facebook Page

Instagram

Skype Name

LinkedIn Profile

Do you have a website?

Your Bio*

Upload your profile image*

Make sure that you read the instructions. The file type needs to be either jpg or png and the maximum file size is 5MB. Such a big file may take a while to upload, so please be patient when submitting the form.

Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.

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Practitioner Profile Submission

MER Training Modules

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