Submit Your Request

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Submit Your Request

INSTRUCTIONS:
1. All hosts MUST be following club founder (@drhabanova) on clubhouse
2. All requests must be submitted at least 14 days in advance
3. Only 1 room / event request may be submitted at a time
4. Any unmet requirements will be rejected immediately
5. Approval is NOT GUARANTEED

Email *

Full Name (First, Last) *

Clubhouse Username *

Cell Phone Number *

My Room / Event Topic is Brain Health Related *

Yes

When Would You Like to Host this Room / Event? *

YYYY

What Time Would You Like to Host this Room / Event? *

What is the Duration of this Room / Event? *

30 minutes

60 minutues

Other:

Room Topic *

Concussion

Memory

Cognition

Brain Fog

Hormones

Autoimmunity

Nutrition & Lifestyle

Mindset

Other:

Required

Provide the Clubhouse Link to the Proposed Room (You must publish your event on the Clubhouse calendar to receive your event link) *

I confirm I am following club founder @dr.habanova on Clubhouse, Instagram, and Twitter. *

Yes

I confirm I have at least (3) co-hosts whom are all members of Brain Health Savvy Club AND are following club founder @dr.habanova *

Yes

I agree to nominate at least 5 women members to Brain Health Savvy Club after my room / event. *

Yes

I agree to NOT sell products, services, or solicit clients in Brain Health Savvy Club. *

Yes

I agree to follow Brain Health Savvy Club guidelines. *

Yes

I understand approval is NOT guaranteed. *

Yes

Thank you for your interest in hosting your room or event within the Brain Health Savvy Club.

Medical Disclaimer:
The Brain Health Savvy Club does not constitute the practice of medicine or other professional healthcare services, including the giving of medical advice. No doctor/patient relationship is formed. The information is intended for the listeners general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. It is not a prescription; listeners must talk with their own primary doctor for medical advice.

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